Real-world Outcomes among Eyes with Center-Involving Diabetic Macular Edema and Good Visual Acuity

Purpose: We aimed to determine long-term visual and anatomical outcomes among patients with center involving-diabetic macular edema and good vision and evaluate factors associated with visual and anatomic outcomes. Materials and Methods: In this retrospective study, all patients with type 2 diabetes aged ≥18 years had seen at the Wilmer Eye Institute between March 2015-June 2018 and with diabetic macular edema confirmed on spectral-domain optical coherence tomography imaging were included, provided they had visual acuity of 20/30 or better in ≥1 eye and a follow-up duration of ≥3 clinic visits. Change in logMAR visual acuity and central 1 mm foveal thickness from baseline, lines of visual acuity gained/lost for overall cohort stratified by treatment were analyzed. Results: Among 197 (243 eyes) participants, mean (± standard deviation) age was 63.4 ± 11.2 years, and half were males. Average duration of follow-up was 1.7 ± 0.7 years. One hundred and forty-six eyes (60%) received anti-vascular endothelial growth factor injections, at an average of 3.7 ± 2.9 injections/eye/year. Mean logMAR visual acuity at baseline was 0.1 ± 0.1 [Snellen 20/25] in both treatment and observation (no anti-vascular endothelial growth factor treatment received during and 3 months prior to the study inclusion period) groups. Final logMAR visual acuity was 0.2 ± 0.2 in the treatment group [Snellen 20/32] versus 0.1 ± 0.3 in observation group [Snellen 20/25]; (p =.23). Mean central foveal thickness changed from 333 ± 66 to 308 ± 45 microns in treatment group and 319 ± 41 to 308 ± 65 microns in observation group. Conclusions: After an average of 1.7 years of follow-up, there were no significant differences in final vision or central foveal thickness irrespective of whether patients received or did not receive treatment with anti-vascular endothelial growth factor injections.