77 results match your criteria center-involved dme


Foveal Müller Cell Cone as a Prognostic OCT Biomarker for Initial Response to Anti-VEGF Treatment in Cystoid Diabetic Macular Edema.

Retina 2021 Jul 23. Epub 2021 Jul 23.

Department of Ophthalmology, Korea University College of Medicine, Seoul, Republic of Korea Department of Ophthalmology, Dongguk University, Ilsan Hospital, Gyeonggi-do, Republic of Korea.

Purpose: To investigate the effect of the foveal Müller cell cone structure on the anatomical and functional response to intravitreal bevacizumab (IVB) treatment in patients with diabetic macular edema (DME).

Methods: In 93 treatment-naïve eyes with center-involved cystic type DME, spectral-domain OCT scans of baseline were retrospectively evaluated to determine the foveal Müller cell cone structure, and prognostic features including length of disorganization in the retinal inner layers (DRIL) and ellipsoid zone (EZ) disruption. The area and circularity of the foveal avascular zone (FAZ) of the superficial and deep capillary plexus (SCP and DCP) 1 month after IVB were evaluated using OCT angiography. Read More

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A Multitask Deep-Learning System to Classify Diabetic Macular Edema for Different Optical Coherence Tomography Devices: A Multicenter Analysis.

Diabetes Care 2021 Jul 27. Epub 2021 Jul 27.

Byers Eye Institute at Stanford, Stanford University School of Medicine, Palo Alto, CA.

Objective: Diabetic macular edema (DME) is the primary cause of vision loss among individuals with diabetes mellitus (DM). We developed, validated, and tested a deep learning (DL) system for classifying DME using images from three common commercially available optical coherence tomography (OCT) devices.

Research Design And Methods: We trained and validated two versions of a multitask convolution neural network (CNN) to classify DME (center-involved DME [CI-DME], non-CI-DME, or absence of DME) using three-dimensional (3D) volume scans and 2D B-scans, respectively. Read More

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Aflibercept versus Ranibizumab as a Second Line Therapy After Bevacizumab for Diabetic Macular Edema.

Clin Ophthalmol 2021 13;15:2975-2980. Epub 2021 Jul 13.

King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia.

Purpose: To compare the visual and anatomic outcomes of aflibercept versus ranibizumab as a second line treatment for persistent diabetic macular edema (DME) after initial bevacizumab injections.

Methods: In this retrospective cohort study, patients with center-involved DME of ≥ 300 μm thickness after bevacizumab intravitreal injections in 2015-2019 were included. Those treated with ranibizumab (R) and aflibercept (A) were grouped as group R and group A, respectively. Read More

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Does conventional laser photocoagulation still have a place in the treatment of diabetic macular edema?

Rom J Ophthalmol 2021 Apr-Jun;65(2):130-135

Department of Ophthalmology, Osmanoglu Hospital, Istanbul, Turkey.

The study aimed to investigate the long-term efficacy of conventional laser photocoagulation in the treatment of diabetic macular edema. In this retrospective study, the records of patients presented with diabetic macular edema (DME) and non-proliferative diabetic retinopathy were reviewed. DME defined as clinically significant macular edema was treated by using argon green or yellow dye laser with focal, grid, and modified grid techniques according to Early Treatment Diabetic Retinopathy Study parameters. Read More

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Comparison of Central Macular Fluid Volume With Central Subfield Thickness in Patients With Diabetic Macular Edema Using Optical Coherence Tomography Angiography.

JAMA Ophthalmol 2021 Jul;139(7):734-741

Casey Eye Institute, Oregon Health & Science University, Portland.

Importance: Diabetic macular edema (DME) is the predominant cause of visual impairment in patients with type 1 or 2 diabetes. Automated fluid volume measurements using optical coherence tomography (OCT) may improve the diagnostic accuracy of DME screening.

Objective: To assess the diagnostic accuracy of an automated central macular fluid volume (CMFV) quantification using OCT for DME. Read More

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Topical ketorolac as an adjunctive treatment with intravitreal bevacizumab in the management of diabetic macular edema: A double-masked placebo-controlled randomized clinical trial.

Graefes Arch Clin Exp Ophthalmol 2021 Apr 15. Epub 2021 Apr 15.

Department of Epidemiology and Biostatistics, Tehran University of Medical Sciences, Tehran, Iran.

Purpose: To evaluate the additional effect of ketorolac eye drops on therapeutic effects of intravitreal Bevacizumab in patients with diabetic macular edema (DME) METHODS: In a randomized clinical trial, 50 patients with center involved DME (macular thickness ≥ 300 microns accompanied by decreased VA (24 < BCVA ≤ 70 ETDRS letters) were enrolled consecutively and randomized 1:1 to receive either bevacizumab plus topical ketorolac (25 patients) or bevacizumab plus artificial tears (25 patients). Patients with proliferative diabetic retinopathy, history of intraocular surgery, intravitreal injection in less than three months, macular photocoagulation less than 6 months and any other concomitant ocular pathologies were excluded from the study. All the patients received three consecutive monthly injections of intravitreal bevacizumab (IVB). Read More

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Outcome of Single Dexamethasone Implant Injection in the Treatment of Persistent Diabetic Macular Edema After Anti-VEGF Treatment: Real-Life Data from a Tertiary Hospital in Jordan.

Clin Ophthalmol 2021 25;15:1285-1291. Epub 2021 Mar 25.

Department of General and Special Surgery, School of Medicine, The Hashemite University, Zarqa, Jordan.

Purpose: To analyze the real-life clinical outcome of a single dexamethasone implant (DEX) injection in the treatment of persistent diabetic macular edema (DME) after anti-vascular endothelial growth factor (anti-VEGF) agents in a sample of the Jordanian population.

Methods: An observational case study design that involved a retrospective chart review analysis in a tertiary hospital in Amman, Jordan. Patients who showed persistent DME after receiving at least six doses of anti-VEGF agents for DME treatment were included. Read More

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Effect of Intravitreous Anti-Vascular Endothelial Growth Factor vs Sham Treatment for Prevention of Vision-Threatening Complications of Diabetic Retinopathy: The Protocol W Randomized Clinical Trial.

JAMA Ophthalmol 2021 Jul;139(7):701-712

Joslin Diabetes Center, Beetham Eye Institute, Harvard Department of Ophthalmology, Boston, Massachusetts.

Importance: The role of anti-vascular endothelial growth factor injections for the management of nonproliferative diabetic retinopathy (NPDR) without center-involved diabetic macular edema (CI-DME) has not been clearly established.

Objective: To determine the efficacy of intravitreous aflibercept injections compared with sham treatment in preventing potentially vision-threatening complications in eyes with moderate to severe NPDR.

Design, Setting, And Participants: Data for this study were collected between January 15, 2016, and May 28, 2020, from the ongoing DRCR Retina Network Protocol W randomized clinical trial, conducted at 64 US and Canadian sites among 328 adults (399 eyes) with moderate to severe NPDR (Early Treatment Diabetic Retinopathy Study severity level, 43-53), without CI-DME. Read More

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Costs of Managing Diabetic Macular Edema with Good Visual Acuity with Aflibercept, Laser or Observation: DRCR Retina Network Protocol V.

Am J Ophthalmol 2021 Mar 10. Epub 2021 Mar 10.

Beetham Eye Institute, Joslin Diabetes Center, Harvard Department of Ophthalmology, Boston, MA.

Purpose: Since eyes with center-involved diabetic macular edema (CI-DME) and good baseline visual acuity (VA) showed no difference in VA loss when managed initially with observation, laser, or aflibercept, understanding the estimated costs of these strategies to the US population is relevant for health care planning.

Design: Pre-planned subgroup analysis from a randomized controlled trial METHODS, SETTING, AND PARTICIPANTS: Total costs for managing participants with CI-DME and good baseline VA assigned to aflibercept (n= 236), laser (n=240), or observation (n = 236) during the 2-year trial were calculated. Using epidemiological data and extrapolating costs, 10-year costs for caring for persons with CI-DME and good baseline VA throughout the US was estimated. Read More

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Factors associated with 1-year visual response following intravitreal bevacizumab treatment for diabetic macular edema: a retrospective single center study.

Int J Retina Vitreous 2021 Mar 4;7(1):17. Epub 2021 Mar 4.

Department of Ophthalmology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.

Background: To explore the association of clinical characteristics and retinal microstructural features on optical coherence tomography in predicting 1-year visual response following intravitreal bevacizumab injections in eyes with visual impairment from center-involved diabetic macular edema (CI-DME).

Methods: Medical records of patients with visual impairment from CI-DME, who initiated intravitreal bevacizumab injections between Jan 2012 and Dec 2016 and were followed for a minimum of 12 months were retrospectively reviewed.

Results: The study included 226 eyes with a mean (SD) baseline visual acuity (VA) of 51. Read More

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Micropulse laser in patients with refractory and treatment-naïve center-involved diabetic macular edema: short terms visual and anatomic outcomes.

Ther Adv Ophthalmol 2021 Jan-Dec;13:2515841420979112. Epub 2021 Jan 19.

Retina department, Instituto Mexicano de Oftalmología I.A.P., Santiago De Querétaro, Querétaro, México.

Purpose: The purpose of the study is to describe visual and anatomic outcomes of 5774nm micropulse laser photocoagulation in eyes with either treatment-naïve or refractory diabetic macular edema (DME) at 3 months.

Methods: This was a prospective case series that recruited 23 consecutive patients (33 eyes) with center-involved DME that was either treatment-naïve or had not responded to prior treatment. Micropulse therapy was performed with the Easy Ret 577 (Quantel Medical, Cournon d'Auvergne, France) diode laser in a high-density manner in eyes with treatment-naïve or refractory DME. Read More

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January 2021

Effect of dexamethasone intravitreal implant for refractory and treatment-naive diabetic macular edema in Taiwanese patients.

J Chin Med Assoc 2021 Mar;84(3):326-330

Department of Ophthalmology, Far Eastern Memorial Hospital, New Taipei City, Taiwan, ROC.

Background: Dexamethasone (DEX) implant has been shown to improve visual and anatomic function in patients with diabetic macular edema (DME). The purpose of this study was to investigate the efficacy and safety of DEX implant between refractory and naive eyes with DME.

Methods: We retrospectively reviewed data from pseudophakic patients with center-involved DME who received DEX implant (1 + as needed retreatment) from May 2015 to May 2017. Read More

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Sensitive Detection of Therapeutic Efficacy with the ETDRS Diabetic Retinopathy Severity Scale.

Clin Ophthalmol 2020 16;14:4385-4393. Epub 2020 Dec 16.

Early Clinical Development, Genentech, Inc, South San Francisco, CA, USA.

Background: The Early Treatment Diabetic Retinopathy Study Diabetic Retinopathy Severity Scale (DRSS) is a standard approach to measure diabetic retinopathy (DR) severity. Many clinical trials evaluating drug intervention for DR rely upon demonstration of a therapeutic effect through measurement of a 2- or 3-step improvement or progression on the DRSS; however, these binary endpoints require a relatively large sample size for a reliable estimate of therapeutic efficacy, especially when the SOC (eg, anti-VEGF) is used as a control. This study was designed to evaluate the sensitivity and statistical efficiency of detecting a drug effect in DR across different DRSS endpoints, and present alternative analytical approaches to enable smaller-size DR trials for detecting a reliable efficacy signal before moving into larger confirmatory DR trials. Read More

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December 2020

Intravitreal Anti-Vascular Endothelial Growth Factor Therapy for Diabetic Macular Edema in Clinical Practice of Single Center: Three-Year Outcomes.

Ophthalmic Res 2021 14;64(3):483-493. Epub 2020 Oct 14.

Department of Ophthalmology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.

Introduction: The objective of this study was to explore visual and anatomical outcomes in patients who underwent intravitreal anti-vascular endothelial growth factor (anti-VEGF) injection for visual impairment from center-involved diabetic macular edema (CI-DME) in clinical practice.

Methods: Medical records of consecutive CI-DME patients who initiated treatment with intravitreal bevacizumab injection between January 2012 and December 2016 and were followed for at least 12 months were retrospectively reviewed. Visual and anatomical changes after treatment over a 36-month period were evaluated. Read More

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October 2020

Review of clinical studies and recommendation for a therapeutic flow chart for diabetic macular edema.

Graefes Arch Clin Exp Ophthalmol 2021 Apr 30;259(4):815-836. Epub 2020 Sep 30.

Department of Ophthalmology and Visual Sciences, Graduate School of Biomedical Sciences, Nagasaki University, Sakamoto 1-7-1, Nagasaki-shi, Nagasaki, 852-8523, Japan.

Diabetic macular edema (DME), characterized by exudative fluid accumulation in the macula, is the most common form of sight-threatening retinopathy in patients with diabetes. The management of DME has changed considerably in recent years, especially following the development of intravitreal anti-vascular endothelial growth factor therapy which has emerged as a first-line therapy for center-involved DME. Laser treatment, intravitreal steroid therapy, and vitrectomy are also important treatment options for DME. Read More

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Macular laser photocoagulation in the management of diabetic macular edema: Still relevant in 2020?

Taiwan J Ophthalmol 2020 Apr-Jun;10(2):87-94. Epub 2020 May 19.

Macula, Vitreous and Retina Associates of Costa Rica, San José, Costa Rica, USA.

Macular laser photocoagulation (MLP) is inferior to intravitreal vascular endothelial growth factor (VEGF) inhibitors in the treatment of center-involved diabetic macular edema (DME). Ultra-widefield fluorescein angiography-guided laser photocoagulation to presumed ischemic areas of the peripheral retina or MLP do not reduce the treatment burden nor improve the visual outcomes of eyes treated with anti-VEGF drugs. Destruction of retinal tissue is not necessary to induce a therapeutic response in DME. Read More

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Comparison of SDOCT Scan Types for Grading Disorganization of Retinal Inner Layers and Other Morphologic Features of Diabetic Macular Edema.

Transl Vis Sci Technol 2020 07 30;9(8):45. Epub 2020 Jul 30.

Beetham Eye Institute, Joslin Diabetes Center, Boston, MA, USA.

Purpose: To assess grading reproducibility of disorganization of the retinal inner layers (DRIL) and other morphologic features of diabetic macular edema (DME) across spectral domain optical coherence tomography (SDOCT) instruments and scan types.

Methods: A cross-sectional study enrolled participants with current or recent center-involved DME. In group A (27 eyes), we obtained two Cirrus scans (512 × 128 macular cube [Cube] and high-definition five-line raster [HD 5-Line]) and two Spectralis scans (high-resolution [HR] and high-speed [HS]). Read More

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Subthreshold yellow laser for fovea-involving diabetic macular edema in a series of patients with good vision: effectiveness and safety of a fovea-sparing technique.

BMC Ophthalmol 2020 Jul 6;20(1):266. Epub 2020 Jul 6.

Ophthalmology department, Joan XXIII University Hospital, Rovira i Virgili University, Mallafré i Guasch, 4, 43002, Tarragona, Spain.

Purpose: Patients with center-involved diabetic macular edema (CI-DME) with good visual acuity (VA) represent a controversial clinical scenario in which a subthreshold laser might be a reasonable approach. We report a case series of patients with CI-DME with VA better than 20/32 who were treated with a subthreshold 577 nm (yellow) laser.

Methods: The area of retinal thickening on OCT was treated with confluent laser spots at individually titrated power. Read More

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Retinal Layers Changes in Patients with Diabetic Macular Edema Treated with Intravitreal Anti-VEGF Agents: Long-Term Outcomes of a Spectral-Domain OCT Study.

Ophthalmic Res 2021 19;64(2):230-236. Epub 2020 Jun 19.

Department of Clinical Therapeutics, Alexandra Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece.

Purpose: The purpose of this study was to investigate retinal layers' changes in patients with diabetic macular edema (DME) treated with anti-vascular endothelial growth factor (anti-VEGF) agents and to evaluate if these changes may affect treatment response.

Methods: Participants in this prospective study were 110 treatment-naïve patients with center involved DME, who were treated with anti-VEGF agents and followed up for at least 12 months. A qualitative and quantitative analysis of retinal layers that can affect visual acuity was performed. Read More

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Effect of dexamethasone intravitreal implant in vitrectomized and nonvitrectomized eyes of Taiwanese patients with treatment-naïve diabetic macular edema.

J Formos Med Assoc 2020 Nov 30;119(11):1619-1625. Epub 2020 May 30.

Department of Ophthalmology, Far Eastern Memorial Hospital, New Taipei City, Taiwan; Department of Medicine, National Taiwan University, Taipei City, Taiwan.

Background/purpose: Vitrectomy may affect intravitreal drug clearance and efficacy for treating diabetic macular edema (DME). This study aimed to evaluate functional and anatomical outcomes of intravitreal dexamethasone (DEX) implant for vitrectomized and nonvitrectomized eyes with treatment-naïve DME in Taiwanese patients.

Methods: In this retrospective single-center study, we reviewed treatment-naïve patients who received DEX implant monotherapy for center-involved DME from January 2015 to May 2017. Read More

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November 2020

Diabetic Population-Based Model to Estimate Impact of Ranibizumab on Diabetic Retinopathy Severity in Patients with Diabetic Macular Edema.

Clin Ophthalmol 2020 7;14:1249-1259. Epub 2020 May 7.

Genentech, Inc., South San Francisco, CA, USA.

Purpose: Estimate effects of ranibizumab on diabetic retinopathy (DR) severity in US Hispanic and non-Hispanic white persons with center-involved diabetic macular edema (DME) causing vision impairment for whom ranibizumab treatment would be considered.

Patients And Methods: This model simulated DR severity outcomes over 2 years in the better-seeing eye using US census, National Health and Nutrition Examination Survey, Wisconsin Epidemiologic Study of Diabetic Retinopathy, and Los Angeles Latino Eye Study data. Baseline DR severity estimated from Diabetic Retinopathy Clinical Research Network trial data. Read More

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Retinopathy Phenotypes in Type 2 Diabetes with Different Risks for Macular Edema and Proliferative Retinopathy.

J Clin Med 2020 May 12;9(5). Epub 2020 May 12.

AIBILI-Association for Innovation and Biomedical Research on Light and Image, 3000-548 Coimbra, Portugal.

Our group reported that three diabetic retinopathy (DR) phenotypes: A, characterized by low microaneurysm turnover (MAT < 6) and normal central retinal thickness (CRT); B, low MAT (<6) and increased CRT, and C, high MAT (≥6), present different risks for development of macular edema (DME) and proliferative retinopathy (PDR). To test these findings, 212 persons with type 2 diabetes (T2D) and mild nonproliferative retinopathy (NPDR), one eye per person, were followed for five years with annual visits. Of these, 172 completed the follow-up or developed an outcome: PDR or DME (considering both clinically significant macular edema (CSME) and center-involved macular edema (CIME)). Read More

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Five-Year Outcomes after Initial Aflibercept, Bevacizumab, or Ranibizumab Treatment for Diabetic Macular Edema (Protocol T Extension Study).

Ophthalmology 2020 09 29;127(9):1201-1210. Epub 2020 Mar 29.

Joslin Diabetes Center, Beetham Eye Institute, Harvard Department of Ophthalmology, Boston, Massachusetts.

Purpose: Assess follow-up treatment and clinical outcomes at 5 years in eyes initially treated with anti-VEGF therapy for center-involved diabetic macular edema (CI-DME) in a 2-year randomized clinical trial.

Design: Multicenter cohort study.

Participants: Participants with diabetic macular edema (DME) and visual acuity (VA) 20/32 to 20/320 enrolled in DRCR. Read More

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September 2020

The association between intravitreal ranibizumab therapy and serum cytokine concentrations in patients with diabetic macular edema.

Mol Vis 2020 1;26:246-256. Epub 2020 Apr 1.

Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, Victoria, Australia.

Aim: To investigate the association between intravitreal ranibizumab therapy and serum cytokine concentrations in patients with diabetic macular edema (DME).

Methods: Twenty-five patients with center-involved DME were recruited prospectively. Serum samples were collected from the patients before and 4 weeks after two ranibizumab injections. Read More

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February 2021

Assessment of the DRCR Retina Network Approach to Management With Initial Observation for Eyes With Center-Involved Diabetic Macular Edema and Good Visual Acuity: A Secondary Analysis of a Randomized Clinical Trial.

JAMA Ophthalmol 2020 04;138(4):341-349

Joslin Diabetes Center, Beetham Eye Institute, Harvard Department of Ophthalmology, Boston, Massachusetts.

Importance: Among eyes with center-involved diabetic macular edema (CI-DME) and good visual acuity (VA), randomized clinical trial results showed no difference in VA loss between initial observation plus aflibercept only if VA decreased, initial focal/grid laser plus aflibercept only if VA decreased, or prompt aflibercept. Understanding the initial observation approach is relevant to patient management.

Objective: To assess the DRCR Retina Network protocol-defined approach and outcomes of initial observation with aflibercept only if VA worsened. Read More

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Revisiting pars plana vitrectomy in the primary treatment of diabetic macular edema in the era of pharmacological treatment.

Taiwan J Ophthalmol 2019 Oct-Dec;9(4):224-232. Epub 2019 Dec 13.

Macula, Vitreous and Retina Associates of Costa RIca, San José, Costa Rica.

Diabetic macular edema (DME) is the most common cause of moderate visual loss in diabetic patients. The current treatment of choice for center-involved DME is anti-vascular endothelial growth factor (VEGF) treatment. Most patients that undergo pharmacological inhibition with anti-VEGF agents need multiple monitoring visits that include optical coherence tomography imaging and multiple injections. Read More

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December 2019

Aflibercept plus micropulse laser versus aflibercept monotherapy for diabetic macular edema: 1-year results of a randomized clinical trial.

Int Ophthalmol 2020 May 9;40(5):1147-1154. Epub 2020 Jan 9.

Ophthalmology Department, Alexandria University, 8 Hassan Allam Street, Smouha, Alexandria, Egypt.

Purpose: To evaluate the role of adjuvant micropulse laser with aflibercept injections in the management of treatment naive center involving DME, looking at decreased treatment burden and increased efficacy as outcomes after 1 year.

Methods: This was a prospective, single center, randomized trial that included 40 eyes (40 patients) with previously untreated center involved DME. Patients were randomly assigned to receive either aflibercept plus micropulse laser (group A) or aflibercept monotherapy (group B). Read More

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Predicting optical coherence tomography-derived diabetic macular edema grades from fundus photographs using deep learning.

Nat Commun 2020 01 8;11(1):130. Epub 2020 Jan 8.

Google Health, Google, Mountain View, CA, USA.

Center-involved diabetic macular edema (ci-DME) is a major cause of vision loss. Although the gold standard for diagnosis involves 3D imaging, 2D imaging by fundus photography is usually used in screening settings, resulting in high false-positive and false-negative calls. To address this, we train a deep learning model to predict ci-DME from fundus photographs, with an ROC-AUC of 0. Read More

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January 2020

Natural history of diabetic macular edema and factors predicting outcomes in sham-treated patients (MEAD study).

Graefes Arch Clin Exp Ophthalmol 2019 Dec 25;257(12):2639-2653. Epub 2019 Oct 25.

Allergan plc, Irvine, CA, USA.

Purpose: To describe the natural history of diabetic macular edema (DME) with respect to best-corrected visual acuity (BCVA) and central retinal thickness (CRT) outcomes and to identify baseline patient characteristics and systemic factors associated with improvement or worsening of outcomes in sham-treated patients.

Methods: The study population was sham-treated patients (n = 350) in the 3-year MEAD registration study of dexamethasone intravitreal implant for treatment of DME. Patients had center-involved DME and received sham intravitreal injections in the study eye at ≥ 6-month intervals. Read More

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December 2019

Five-Year Cost-effectiveness of Intravitreous Ranibizumab Therapy vs Panretinal Photocoagulation for Treating Proliferative Diabetic Retinopathy: A Secondary Analysis of a Randomized Clinical Trial.

JAMA Ophthalmol 2019 12;137(12):1424-1432

Beetham Eye Institute, Joslin Diabetes Center, Boston, Massachusetts.

Importance: The DRCR Retina Network Protocol S randomized clinical trial suggested that the mean visual acuity of eyes with proliferative diabetic retinopathy (PDR) treated with ranibizumab is not worse at 5 years than that of eyes treated with panretinal photocoagulation (PRP). Moreover, the ranibizumab group had fewer new cases of diabetic macular edema (DME) with vision loss or vitrectomy but had 4 times the number of injections and 3 times the number of visits. Although 2-year cost-effectiveness results of Protocol S were previously identified, incorporating 5-year data from Protocol S could alter the longer-term cost-effectiveness of the treatment strategies from the perspective of the health care system. Read More

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December 2019