Management Of Patients With Dme With Good Visual Acuity In Routine Clinical Practice

BACKGROUND AND OBJECTIVE: To determine outcomes of eyes with diabetic macular edema (DME) and best visual acuity (BVA) of 20/25 or better in routine clinical practice.PATIENTS AND METHODS: Retrospective study of 72 patients with DME and BVA of 20/25 or better. Patients were divided by anti-vascular endothelial growth factor (VEGF) treatment regimen: early (Group A), delayed (Group B), and none (Group C).RESULTS: Group A had higher baseline central subfield thickness (CST) (325 +/- 62 pm) compared to Groups B (292 +/- 24 pm) and C (296 +/- 35 gm) (P = .033). All groups had similar 24-month CST (299 +/- 62 pm, 280 +/- 64 pm, 296 +/- 65 pm; P = .61). There was no difference in baseline BVA among groups (81.9 +/- 2.4, 83.2 +/- 2.4, 82.4 +/- 2.5 Early Treatment Diabetic Retinopathy Study [ETDRS] letters. respectively; P = .290), but at 6 months, Group A had lower BVA (76.6 +/- 9.6 ETDRS letters) than groups B (81.9 +/- 3.3 ETDRS letters) and C (82.4 +/- 5.0 ETDRS letters) (P = .008). There was no difference among groups in 24-month BVA (78.9 +/- 6.6, 78.4 +/- 12.3, and 80.6 +/- 6.9 ETDRS letters, respectively; P = .448).CONCLUSION: Although observation may be indicated in eyes with stable BVA and CST less than 300 mu m, anti-VEGF stabilizes BVA in eyes with CST greater than 300 mu m and eyes with declining BVA.