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Prognosis of patients with diabetic macular edema before Japanese approval of anti-vascular endothelial growth factor

Japanese Journal of Ophthalmology volume 59, pages 244–251 (2015)Cite this article

Abstract

Purpose

To examine the prognosis of patients with diabetic macular edema (DME) before Japanese approval of antivascular endothelial growth factor (VEGF).

Methods

This retrospective study included 135 eyes of 115 patients who received treatments (photocoagulation, pharmacological treatments, vitrectomy) for DME between January 2003 and August 2012. The best-corrected visual acuity (BCVA) before and 1, 3, 6, 12, and 24 months after treatment was examined. BCVA was classified based on the decimal value of BCVA before treatment as good (BCVA > 0.7, BCVA = 0.7), moderate (BCVA > 0.7 but <0.2), or poor (BCVA < 0.2, BCVA = 0.2), and each prognosis of BCVA was investigated.

Results

Thirty-five (25.9 %) patients were classified with good BCVA, while 69 (51.1 %) had moderate and 31 (23.0 %) poor BCVA. Following 24 months of treatment, the averaged good BCVA maintained its value (0.0513 ± 0.0954 to 0.0773 ± 0.258). Similarly, the averaged moderate BCVA maintained its value (0.449 ± 0.169 to 0.441 ± 0.431), whereas the averaged poor BCVA significantly improved (1.070 ± 0.291 to 0.879 ± 0.361: p < 0.001). Specifically, the averaged BCVA of patients who initially received vitrectomy increased 0.380 logMAR after 24 months (0.859 ± 0.414 to 0.479 ± 0.549).

Conclusion

DME patients with good BCVA at the time of initial treatment generally maintained the averaged BCVA at 24 months, while patients with moderate BCVA did not significantly improve without a standard regimen of anti-VEGF therapy. However, the results indicate that early vitrectomy is a potential treatment option for DME patients with poor BCVA.

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Conflicts of interest

S. Serizawa, None; K. Ohkoshi, None; Y. Minowa, None; O. Takahashi, None.

Author information

Affiliations

  1. Department of Ophthalmology, St. Luke’s International Hospital, 9-1 Akashicho, Chuo, Tokyo, Japan

    Satoshi Serizawa, Kishiko Ohkoshi & Yuko Minowa

  2. Department of Internal Medicine, St. Luke’s International Hospital, Chuo, Tokyo, Japan

    Osamu Takahashi

Authors
  1. Satoshi Serizawa
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  2. Kishiko Ohkoshi
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  3. Yuko Minowa
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  4. Osamu Takahashi
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Correspondence to Satoshi Serizawa.

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Serizawa, S., Ohkoshi, K., Minowa, Y. et al. Prognosis of patients with diabetic macular edema before Japanese approval of anti-vascular endothelial growth factor. Jpn J Ophthalmol 59, 244–251 (2015). https://doi.org/10.1007/s10384-015-0384-2

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  • DOI: https://doi.org/10.1007/s10384-015-0384-2

Keywords

  • Diabetic macular edema
  • Ranibizumab
  • Vitrectomy
  • Optic coherence tomography
  • Diabetic retinopathy