Chitturi Sai Prashanti, Venkatesh Ramesh, Mangla Rubble, Parmar Yash, Sangoram Rohini, Yadav Naresh Kumar, Chhablani Jay
Dept. of Retina and Vitreous, Narayana Nethralaya, #121/C, 1st R Block, Chord Road, Rajaji Nagar, 560010, Bengaluru, Karnataka, India.
Medical Retina and Vitreoretinal Surgery, University of Pittsburgh School of Medicine, 203 Lothrop Street, Suite 800, Pittsburg, PA, 15213, USA.
Int J Retina Vitreous. 2023 Mar 30;9(1):22. doi: 10.1186/s40942-023-00463-y.
To compare real-life data on delayed intravitreal treatment of diabetic macular edema (DME) patients to early treatment.
In this single-centre, retrospective, interventional, comparative study, DME patients were divided into two groups based on when they received treatment: Group 1 - received treatment within 24 weeks and Group 2 - at or after 24 weeks from the time of treatment advice. Visual acuity and central subfield thickness (CSFT) changes were compared at various time points. Reasons for delaying treatment were noted.
The study included 109 (Group 1-94; Group 2-15) eyes. When treatment was advised, demographic profile, diabetes duration, glucose control and VA between two groups were comparable. At this point, CSFT was higher in Group 1 than in Group 2 (p = 0.036). At injection time, Group 2 had better VA and lower CSFT than Group 1 (p < 0.05). Group 2's VA (53.4 ± 12.67) was significantly lower than Group 1's (57.38 ± 20.01) after 1-year treatment. At 1-year, CSFT decreased in Group 1 and increased in Group 2. Group 1 had mean improvement of + 7.6 letters and Group 2 had a decline of -6.9 letters. Group 2 required more intravitreal anti-VEGF (median - 3; IQR: 2-4), steroid injections (median - 4; IQR: 2-4) and focal laser sessions (median - 4; IQR: 2-4).
Late-treated DME eyes needed more injections and focal laser sessions than early treated eyes. Adherence to early treatment of DME in real-life will help prevent long-term vision loss.
比较糖尿病性黄斑水肿（DME）患者延迟玻璃体腔内治疗与早期治疗的实际数据。
在这项单中心、回顾性、干预性、对比研究中，DME患者根据接受治疗的时间分为两组：第1组——在24周内接受治疗；第2组——在治疗建议时间的24周及以后接受治疗。比较不同时间点的视力和中心子野厚度（CSFT）变化。记录延迟治疗的原因。
该研究纳入了109只眼（第1组94只；第2组15只）。在给出治疗建议时，两组之间的人口统计学特征、糖尿病病程、血糖控制和视力相当。此时，第1组的CSFT高于第2组（p = 0.036）。在注射时，第2组的视力优于第1组，CSFT低于第1组（p < 0.05）。治疗1年后，第2组的视力（53.4±12.67）显著低于第1组（57.38±20.01）。在1年时，第1组的CSFT下降，第2组的CSFT上升。第1组平均提高了7.6个字母，第2组下降了6.9个字母。第2组需要更多的玻璃体腔内抗VEGF注射（中位数 - 3；四分位间距：2 - 4）、类固醇注射（中位数 - 4；四分位间距：2 - 4）和局灶性激光治疗（中位数 - 4；四分位间距：2 - 4）。
与早期治疗的眼睛相比，延迟治疗的DME眼睛需要更多的注射和局灶性激光治疗。在实际生活中坚持对DME进行早期治疗将有助于预防长期视力丧失。
