Retina-The Journal of Retinal and Vitreous Diseases最新文献

{"title":"The skewer technique combined with phacoemulsification to remove the lens dislocated into the vitreous cavity.","authors":"Zigan Zhou, Binghua Guo, Zhong Lin, Zhixiang Hu, Xingyi Wu, Ronghan Wu","doi":"10.1097/IAE.0000000000004305","DOIUrl":"https://doi.org/10.1097/IAE.0000000000004305","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the efficacy and safety outcomes of our newly developed skewer technique in the management of lens dislocation.</p><p><strong>Methods: </strong>A total of 21 eyes with lens dislocation were treated with this surgical technique. We focused on best-corrected visual acuity (BCVA), intraocular pressure, and complications of retinal damage at 3 months post-surgery.</p><p><strong>Results: </strong>The mean age of the patients was 60.20 ± 10.73 (range: 41-85) years, and the average axial length was 25.40 ± 2.35 (range: 22.30-32.35) mm. The BCVA at 3 months post-surgery showed a significant improvement compared to preoperative measurements. No intraoperative or postoperative retinal damage occurred in any eyes treated with this new technique.</p><p><strong>Conclusion: </strong>The \"skewer\" technique we developed is an innovative solution for addressing lens dislocation. Phacoemulsification can be performed in the anterior chamber utilizing a light guide to control the position and movement of the lens. This approach eliminates the need for perfluorocarbon liquid or extensive pars plana scleral sclerotomy. Based on postoperative outcomes from a series of patients who underwent this procedure, the technique is highly safe and feasible.</p>","PeriodicalId":54486,"journal":{"name":"Retina-The Journal of Retinal and Vitreous Diseases","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142481036","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Visual acuity loss after vitrectomy for epiretinal membrane in eyes with glaucoma.","authors":"Tomomi Higashide, Sachiko Udagawa, Yoko Yamashita, Shunsuke Tsuchiya, Tetsuhiko Okuda, Kazuaki Kadonosono, Kazuhisa Sugiyama","doi":"10.1097/IAE.0000000000004308","DOIUrl":"https://doi.org/10.1097/IAE.0000000000004308","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the incidence and predictors of visual acuity (VA) loss after surgery for epiretinal membrane (ERM) in glaucomatous eyes.</p><p><strong>Methods: </strong>A prospective cohort study examining VA and central visual fields (VFs, Humphrey 10-2) at baseline and 3, 6, and 12 months after vitrectomy with internal limiting membrane peeling for ERM in the glaucoma (47 eyes of 43 patients) and control (46 eyes of 46 patients) groups. VA and VF tests were repeated for ≥1.5 years only for the glaucoma group. Factors associated with substantial VA loss [>0.2 logMAR (about >2 lines on the Snellen chart) from baseline] were determined using a Cox proportional hazards model.</p><p><strong>Results: </strong>Until 1 year postoperatively, no substantial VA loss occurred and postoperative VA improved significantly and similarly in both groups (P<0.001 vs. baseline, P>0.15 between two groups). Substantial VA loss occurred in eight eyes (17%) with glaucoma ≥1.5 years postoperatively, which was associated with worse preoperative VF mean deviation and 1-year mean decrease in postoperative VF mean deviation (hazard ratio = 0.83, 0.72; P = 0.018, <0.001, respectively).</p><p><strong>Conclusions: </strong>Substantial VA loss occurred long after ERM surgery in eyes with glaucoma, which was associated with worse preoperative central VFs and greater central VF deterioration during the first postoperative year.</p>","PeriodicalId":54486,"journal":{"name":"Retina-The Journal of Retinal and Vitreous Diseases","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142513058","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fluid Resolution Without Shortening Injection Interval During Subretinal Fluid-tolerating Treatment in Neovascular Age-related Macular Degeneration.","authors":"Ji Hyun Lee, Sang Min Park, Jae Hui Kim","doi":"10.1097/IAE.0000000000004299","DOIUrl":"https://doi.org/10.1097/IAE.0000000000004299","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the incidence and factors associated with subretinal fluid(SRF) resolution during SRF-tolerating treatment in patients with neovascular age-related macular degeneration(AMD).</p><p><strong>Methods: </strong>This retrospective study included patients diagnosed with neovascular AMD who exhibited fovea-involving residual SRF persisting for at least 6 months during aflibercept treatment. Patients who showed SRF resolution despite maintaining the injection intervals were included in the resolution group, while those who exhibited persisting SRF throughout the study period were included in the non-resolution group. The incidence and associated factors of SRF resolution without reducing the injection interval were evaluated. Furthermore, the frequency of successfully extending the injection intervals while maintaining SRF resolution was identified.</p><p><strong>Results: </strong>In total, 65 patients with neovascular AMD were included(32 and 33 in the resolution and non-resolution groups, respectively). When compared to the non-resolution group, the resolution group showed a lower mean height of SRF(67.7±33.4 vs 109.9±44.9 µm, P<0.001) and a lower maximum height of SRF(138.3±88.6 vs 176.2±76.9 µm, P=0.034). In multivariate analysis, the mean SRF height(P=0.001), maximum SRF height(P=0.006), and interval of anti-vascular endothelial growth factor injections(P=0.023) were significantly associated with the resolution of SRF. In the resolution group, 14 patients(43.8%) successfully expanded the injection interval.</p><p><strong>Conclusions: </strong>During SRF-tolerating treatment for neovascular AMD, a substantial proportion of patients exhibited resolution of fluid without shortening the injection interval. Patients with lesser residual SRF during treatment were more likely to achieve fluid resolution. Following SRF resolution, injection intervals can be extended in more than 40% of patients.</p>","PeriodicalId":54486,"journal":{"name":"Retina-The Journal of Retinal and Vitreous Diseases","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142513051","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Analysis of Henle's fiber layer and outer retinal layers in cone dystrophy.","authors":"Cem Kesim, Selahattin Cansiz, Umit Yasar Guleser, Cigdem Gunduz-Demir, Murat Hasanreisoglu","doi":"10.1097/IAE.0000000000004306","DOIUrl":"https://doi.org/10.1097/IAE.0000000000004306","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate Henle's Fiber Layer (HFL) thickness and volume parameters in patients with cone photoreceptor atrophy with directional optical coherence tomography (D-OCT).</p><p><strong>Methods: </strong>Macular 20°×20° standard and D-OCT images were acquired from patients diagnosed with hereditary cone dystrophy with evident foveal ellipsoid zone defect in OCT, and age-matched healthy controls. Thickness and volume parameters of HFL, outer nuclear layer (ONL) and retinal layers between ellipsoid zone and Bruch membrane complex (EZ-BM) were calculated from manual segmentation through D-OCT images and comparative analysis is performed.</p><p><strong>Results: </strong>Twelve eyes of 6 patients were compared to 12 eyes of 6 age-matched healthy controls (mean age: 29.5±16.6 and 26.6±3.9 years respectively; P=0.162). Patients had lower total HFL volume (0.45±0.03 and 0.85±0.15 mm3; P<0.001) and mean HFL thickness (16.1±1.1 and 30.1±5.3 µm; P<0.001) than healthy controls. Central subfield, parafoveal and perifoveal ETDRS zone HFL parameters in patients were significantly lower than healthy controls. A centrifugal correlation was found between central ONL and the corresponding parafoveal HFL (Spearman's rho: 0.785; P<0.001).</p><p><strong>Conclusion: </strong>HFL assessment might be a useful OCT biomarker in patients with cone photoreceptor atrophy. HFL thinning is observed in foveal, parafoveal and perifoveal areas of patients with cone photoreceptor atrophy, while volume reduction in ONL and EZ-BM components were limited to central and parafoveal zones.</p>","PeriodicalId":54486,"journal":{"name":"Retina-The Journal of Retinal and Vitreous Diseases","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142513047","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transretinal puncture with a 41G cannula for posterior residual subretinal fluid in fovea-off retinal detachments treated by vitrectomy VS fluid tolerance VS other conventional drainage techniques: a comparative study.","authors":"Maxime Desira, Thibault Ruiz, Alban Comet, Frederic Matonti, John Conrath, Robinson Gravier-Dumonceau, Charles Delaporte, Christophe Morel, François Devin, Thierry David, Pierre Gascon","doi":"10.1097/IAE.0000000000004309","DOIUrl":"https://doi.org/10.1097/IAE.0000000000004309","url":null,"abstract":"<p><strong>Purpose: </strong>To compare functional and anatomical outcomes between posterior drainage of residual fluid using a 41G cannula, fluid tolerance (R-SRF), and conventional complete drainage methods, including removal through peripheral retinal breaks (PRB), perfluorocarbon liquid (PFCL), and posterior retinotomy (PR).</p><p><strong>Methods: </strong>In this retrospective, multicenter study, we evaluated cases for visual acuity (VA) at 3 months of follow-up. Secondary outcomes included surgical success, postoperative metamorphopsia, shifts, full-thickness folds (FTF), optical coherence tomography (OCT) parameters, and safety. Subgroup analyses were also conducted.</p><p><strong>Results: </strong>VA did not differ significantly between the three main groups. Subgroup analyses revealed worse VA for PR with 1.131 LogMAR (20/270 in Snellen conversion, p=0,002), with significantly more grade C proliferative vitreoretinopathy (PVR, 40.0%, p=0,003). R-SRF tended to offer better secondary outcomes, without statistical significance except for postoperative epiretinal membrane (ERM, 30.8%, p=0,041). Subgroup analyses found significantly more shifts with PFCL (91,7%, p=0,036). No cases of postoperative FTF or macular holes were observed with the 41G.</p><p><strong>Conclusion: </strong>Our study introduced the 41G technique, indicating favourable outcomes for fovea-off retinal detachments. Nevertheless, fluid tolerance appeared to be the best option, offering a cost-effective and faster method, with an optimal microstructural profile and VA comparable to that of complete drainage techniques.</p>","PeriodicalId":54486,"journal":{"name":"Retina-The Journal of Retinal and Vitreous Diseases","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142513057","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"6/0 prolene double-flanged IOL sutureless scleral fixation with a 27-gauge needle for intraocular lens surgery.","authors":"Shu-I Pao, Yun-Hsiang Chang, Jiann-Torng Chen","doi":"10.1097/IAE.0000000000004289","DOIUrl":"https://doi.org/10.1097/IAE.0000000000004289","url":null,"abstract":"<p><strong>Purpose: </strong>To report our initial experience of a modified intraocular lens (IOL) scleral fixation technique using 6/0 prolene in a double-flanged sutureless technique with a 27-gauge needle.</p><p><strong>Methods: </strong>29 consecutive patients with IOL surgery were retrospectively reviewed between December 2021 and October 2023. Early Treatment Diabetic Retinopathy Study (ETDRS) letters, spherical equivalent (SE), astigmatism axial degree and intraocular pressure (IOP) were evaluated at baseline, and 1, 2, 3, and 6 months postoperatively. Surgery-related complications were evaluated during follow-up.</p><p><strong>Results: </strong>ETDRS letters or SE at 1, 2, 3, and 6 months postoperation was significantly improved compared to baseline levels. Patients with younger (estimate [SE] = 8.011 [2.485], p = 0.006), preoperative lens drop (estimate [SE] = 8.621 [2.906], p = 0.009), idiopathic cataract (estimate [SE] = 6.021 [2.099], p = 0.048), high baseline ETDRS letters (estimate [SE] = 15.449 [2.352], p < 0.001), or low baseline SE (estimate [SE] = 6.357 [2.406], p = 0.018) had the greatest improvement in ETDRS letters during follow-up. Patients with preoperative lens or IOL dislocation had a greater postoperative SE improvement than those with preoperative lens or IOL subluxation (dislocation vs. subluxation: estimate [SE] = -189.235 [70.692], p = 0.016). There were no cases of vitreous hemorrhage, cystoid macular edema, endophthalmitis, subluxation or dislocation were observed during the 6-month follow-up.</p><p><strong>Conclusions: </strong>Our modified IOL scleral fixation technique is a simple, safe, efficient method that avoids haptic manipulation and slippage, reduces postoperative complications, achieves completely sutureless surgery, and results in an achievement of surgical refractive goals.</p>","PeriodicalId":54486,"journal":{"name":"Retina-The Journal of Retinal and Vitreous Diseases","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142513046","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incidence and progression of age-related macular degeneration among patients with and without obstructive sleep apnea: a national cohort study.","authors":"Marian Blazes, Caitlyn Ngadisastra, Pei-Ru Li, Cecilia S Lee, Jiahn-Shing Lee, Lai-Chu See, Ken-Kuo Lin","doi":"10.1097/IAE.0000000000004293","DOIUrl":"https://doi.org/10.1097/IAE.0000000000004293","url":null,"abstract":"<p><strong>Purpose: </strong>Obstructive sleep apnea (OSA) may increase the risk of age-related macular degeneration (AMD) due to repetitive oxygen deprivation or other mechanisms, though whether OSA increases the risk of AMD progression is unknown. We analyzed associations between OSA and AMD risk in the Taiwanese population.</p><p><strong>Methods: </strong>We identified patients diagnosed with OSA between 2000 and 2018 in the Taiwan National Health Insurance Research Database and used 1:1 propensity score matching on demographics and co-morbidities to create a non-OSA cohort. We used Cox proportional hazard modeling to investigate the risk of AMD and the risk of progression from nonexudative to exudative AMD in OSA versus non-OSA patients.</p><p><strong>Results: </strong>A total of 66,869 OSA patients were matched with 66,869 non-OSA patients. The hazard ratio (HR) of AMD in the OSA cohort was 1.36 (95% confidence interval[CI]: 1.31-1.43, p<.0001). The HR for progression from nonexudative to exudative AMD for the OSA cohort was 0.94 (95%CI: 0.77-1.14, p=0.5073).</p><p><strong>Conclusion: </strong>OSA is associated with a higher risk of developing AMD. However, no increased risk of AMD progression is observed among people with OSA and existing non-exudative AMD.</p>","PeriodicalId":54486,"journal":{"name":"Retina-The Journal of Retinal and Vitreous Diseases","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142513052","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Role of Visual Evoked Potential and Ocular Trauma Score as Predictors of Visual Recovery in Eye Globe Injuries.","authors":"Brice N Vofo, Ayala Katzir, Mohammad Homiedat, Antonio Rivera, Fernando Estrella, Samer Khateb, Tareq Jaouni","doi":"10.1097/IAE.0000000000004307","DOIUrl":"https://doi.org/10.1097/IAE.0000000000004307","url":null,"abstract":"<p><strong>Purpose: </strong>Evaluate visual evoked potential (VEP) and ocular trauma score (OTS) efficacy in predicting visual potential in globe trauma without optic nerve involvement.</p><p><strong>Methods: </strong>A retrospective cohort study analyzed clinical data from eye globe injury cases undergoing flash VEP between January 2000 and May 2021. Inclusion criteria: flash VEP completion within 48 hours, pre-surgical intervention. Exclusions: head trauma, optic nerve injuries. Abnormal VEP: <7 µV amplitudes, >120ms latencies. The OTS was computed, and penetrating injuries were categorized.</p><p><strong>Results: </strong>Of 85 eyes meeting the criteria (mean age: 31.9±20.6 years, 82.4% male), the median follow-up was 22 months. OTS directly correlated with the amount of Early Treatment Diabetic Retinopathy Study letters gained at follow-up and was inversely correlated with ocular penetration extent, and VEP signal amplitude. VEP amplitude is inversely correlated with maintaining/improving visual acuity. Positive predictive value for normal VEP predicting maintained/improved visual acuity: 75.6%, negative predictive value: 21.3%. In blunt trauma, baseline VEP amplitude had superior predictive value compared to penetrating injury.</p><p><strong>Conclusion: </strong>This study highlights a correlation between VEP signal amplitude and OTS with visual outcomes in traumatic eye injuries without optic nerve involvement. OTS emerges as a reliable VEP substitute, particularly in blunt trauma cases, where baseline VEP amplitude predicts visual recovery more accurately than penetrating injuries.</p>","PeriodicalId":54486,"journal":{"name":"Retina-The Journal of Retinal and Vitreous Diseases","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142513055","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"COMPARING STAGES OF DIABETIC RETINOPATHY WITH SYSTEMIC VASCULAR STATUS USING FINGER PHOTOPLETHYSMOGRAPHY.","authors":"Nurshazwani Ab Rahman, Kalaivani Chellapan, Poh Yan Ong, Azian Adnan, Norshamsiah Md Din","doi":"10.1097/IAE.0000000000004297","DOIUrl":"https://doi.org/10.1097/IAE.0000000000004297","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate systemic vascular fitness measured by finger photoplethysmography (PPG) in diabetic retinopathy (DR).</p><p><strong>Methods: </strong>This was a cross sectional observational study on type-II Diabetes Mellitus patients from October 2020 to May 2021. Data collected include systolic/diastolic blood pressure (BP), visual acuity, HbA1c, and central macular thickness (CMT). DR severity was categorised using the ETDRS classification. PPG signals were acquired using pulse-oximeter modules (OEM-60, Dolphin Medical Inc) measured for 90 seconds at 275Hz sampling rate and 16-bits resolution which records photoplethysmography fitness index (PPGF), vascular-risk prediction index (VRPI) and vascular age (VascA).</p><p><strong>Results: </strong>One-hundred-and-forty-one patients were equally distributed into six DR categories. Mean age was 58.8±9.9 years, with female-to-male ratio of 1.27. There were significant differences in mean systolic (125.5±10.0mmHg, p=0.007) and diastolic-BP (80.0±8.8mmHg), mean HbA1c (7.6±1.9%, p=0.005), median LogMAR (0.3, IQR:0.2-0.5, p<0.001) and CMT (p=0.003) across DR severity. Significant differences were also seen in PPGF (p=0.001), VRPI (p<0.001) and VascA (p=0.001), with poorer values in severe compared to mild/moderate DR. After adjusting for age, BP and HbA1c, PPGF reduces by 3.3% (regression coefficient, b= -3.27, p<0.001), VascA increases by 2.5 years (b=2.54, p=0.002) and VRPI increases by 3.1 (b= 3.08, p<0.001) with every DR worsening.</p><p><strong>Conclusions: </strong>More severe DR were associated with poorer PPG vascular markers.</p>","PeriodicalId":54486,"journal":{"name":"Retina-The Journal of Retinal and Vitreous Diseases","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142513050","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Alteration of treatment choices and the visual prognosis for diabetic macular edema in the era of anti-VEGF drugs: Analysis of the STREAT-DME 2 study.","authors":"Masahiko Shimura, Takao Hirano, Eiko Tsuiki, Yoshihiro Takamura, Yuki Morizane, Kunihiko Akiyama, Kaori Yamamoto, Taichi Hikichi, Takashi Koto, Takamasa Kinoshita, Sentaro Kusuhara, Shigeo Yoshida, Shin-Ichi Sakamoto, Kazuhiro Kimura, Masahiko Sugimoto, Teruyo Kida, Yoshinori Mitamura, Yoko Takatsuna, Noriaki Washio, Rie Osaka, Tetsuki Ueda, Akira Minamoto, Jiro Kogo, Fumiki Okamoto, Hiroshi Enaida, Yoshihito Sakanishi, Taiji Nagaoka, Fumi Gomi, Mariko Sasaki, Hiroto Terasaki, Tsuyoshi Iwase, Tomoaki Tatsumi, Kosuke Nishi, Kei Shinoda, Shunichiro Ueda, Tomoko Ueda-Consolvo, Hiroyuki Nakashizuka, Toshinori Murata, Shigehiko Kitano, Taiji Sakamoto","doi":"10.1097/IAE.0000000000004301","DOIUrl":"https://doi.org/10.1097/IAE.0000000000004301","url":null,"abstract":"<p><strong>Purpose: </strong>To assess the real-world outcome of best-corrected visual acuity (BCVA) following 2-year intervention for treatment-naïve diabetic macular edema (DME) since the approval of anti-vascular endothelial growth factor (VEGF) therapy.</p><p><strong>Methods: </strong>A total of 1,780 treatment-naïve eyes with DME for which intervention was initiated between 2015 and 2019, and which were followed for 2 years, were extracted from the longitudinal medical records of 37 retinal disease institutions in Japan. Interventions included anti-VEGF therapy, topical corticosteroid therapy, macular photocoagulation, and vitrectomy. The baseline and final BCVA, and the number and timing of interventions were recorded. Eyes were classified according to the year in which intervention was initiated.</p><p><strong>Results: </strong>Over a 2-year period, BCVA improved annually, finally reaching 7 letters. The proportion of eyes in which good vision was maintained (BCVA >20/40) increased to 73.3% in the latest period. The administration of anti-VEGF therapy remained stable, accounting for approximately 90% of eyes. Notably, the proportion of eyes receiving anti-VEGF drugs as first-line treatment increased dramatically to approximately 80%.</p><p><strong>Conclusion: </strong>Anti-VEGF therapy has become the first-line treatment since the approval of anti-VEGF drugs for DME. These findings reflect the evolution of DME treatment and highlight the superiority of anti-VEGF therapy and its increased uptake over time.</p>","PeriodicalId":54486,"journal":{"name":"Retina-The Journal of Retinal and Vitreous Diseases","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142481032","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}