Background/aims To investigate the yearly change of real-world outcomes for best corrected visual acuity (BCVA) after 2-year clinical intervention for treatment-naïve diabetic macular oedema (DMO).
Methods Retrospective analysis of aggregated, longitudinal medical records obtained from 27 retina specialised institutions in Japan from Survey of Treatment for DMO database. A total of 2049 treatment-naïve centre involving DMO eyes of which the initial intervention started between 2010 and 2015, and had been followed for 2 years, were eligible. As interventions, antivascular endothelial growth factor (VEGF) agents, local corticosteroids, macular photocoagulation and vitrectomy were defined. In each eye, baseline and final BCVA, the number of each intervention for 2 years was extracted. Each eye was classified by starting year of interventional treatment.
Results Although baseline BCVA did not change by year, 2-year improvement of BCVA had been increased, and reached to +6.5 letters in the latest term. There is little difference among starting year about proportions of eyes which BCVA gained >15 letters, in contrast to those which lost >15 letters were decreased by year. The proportion of eyes receiving anti-VEGF therapy was dramatically increased, while those receiving the other therapies were gradually decreased. The proportion of eyes which maintained socially good vision of BCVA>20/40 has been increased and reached to 59.0% in the latest term.
Conclusion For recent years, treatment patterns for DMO have been gradually but certainly changed; as a result, better visual gain, suppression of worsened eyes and better final BCVA have been obtained. Anti-VEGF therapy has become the first-line therapy and its injection frequency has been increasing.
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Collaborators Japan Clinical Retina Study (J-CREST) group: Statistical analysis: Katsunori Shimada PhD in STATZ Institute Inc. Contributions of the authors by data acquisition: Hidetaka Noma MD, Ryosuke Motohashi MD, Osamu Kotake MD and Makoto Imazeki MD in Department of Ophthalmology, Tokyo Medical University, Hachioji Medical Center. Eiko Tsuzuki MD in Department of Ophthalmology and Visual Sciences, Graduate School of Biomedical Sciences, Nagasaki University. Shizuya Saika MD in Department of Ophthalmology, Wakayama Medical University. Ryutaro Yamanishi MD in Department of Ophthalmology, National Tokyo Medical Center. Takao Kashiwagi MD and Fumi Gomi MD in Department of Ophthalmology, Hyogo College of Medicine. Takashi Katome MD in Department of Ophthalmology, Institute of Biomedical Sciences, Tokushima University Graduate School. Keiichi Nishikawa MD in Department of Ophthalmology, Japanese Red Cross Otsu Hospital. Mitsuru Nakazawa MD in Department of Ophthalmology, Hirosaki University Graduate School of Medicine. Masaru Takeuchi MD in Department of Ophthalmology, National Defense Medical College. Nahoko Ogata MD in Department of Ophthalmology, Nara Medical University.
Funding This study was supported by clinical research grant-in aid by Tokyo Medical University. This study is registered with the University Hospital Medical Information Network individual case data repository (UMIN#23160).
Competing interests None declared.
Patient consent for publication Not required.
Ethics approval The study protocol was reviewed and approved by the Institutional Review Board of each participating centre.
Provenance and peer review Not commissioned; externally peer reviewed.
Data availability statement Data are available upon reasonable request. All data were stored and managed in a statistical institution and available upon reasonable request.
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