A retrospective study has determined that the gradual change in treatment patterns for diabetic macular edema (DME) have led to better visual gain, slower progression and better final best-corrected visual acuity (BCVA). Researchers in Japan used the medical records from 27 retina specialists to investigate the yearly change of real-world outcomes for BCVA after a two-year clinical intervention for treatment-naïve DME.

The study included a total of 2,049 treatment-naïve center-involving DME eyes and found BCVA improved up to +6.5 letters in two years. The researchers also noted that the proportion of eyes that maintained BCVA greater than 20/40 has also increased, reaching up to 59.0% in the two-year period.

After examining interventions such as anti-VEGF agents, local corticosteroids, macular photocoagulation and vitrectomy, the researchers noted that anti-VEGF has become the first-line therapy, and its injection frequency has been increasing. This was also indicated by the increase in proportion of eyes receiving anti-VEGF therapy, while those receiving the other therapies gradually decreased. 

Shimura M, Kitano S, Muramatsu D, et al. Real-world management of treatment-naïve diabetic macular oedema: 2-year visual outcome focusing on the starting year of intervention from STREAT-DMO study. Br J Ophthalmol. March 13, 2020. [Epub ahead of print].