Chalasani Meghana, Maatouk Christopher, Markle Jonathan, Singh Rishi P, Talcott Katherine E
Center for Ophthalmic Bioinformatics, Cole Eye Institute, Cleveland Clinic, Cleveland, OH, USA.
Department of Ophthalmology, University of Chicago Medical Center, Chicago, IL, USA.
J Vitreoretin Dis. 2024 Dec 13:24741264241305123. doi: 10.1177/24741264241305123.
To identify baseline characteristics that predict visual outcomes after a lapse in treatment among patients with diabetic macular edema (DME) who received intravitreal antivascular endothelial growth factor injections. In this retrospective study, patients with DME who had lapses in treatment of 3 months or longer were separated into 2 groups (stable vision, n = 201; vision loss, n = 61) based on an Early Treatment Diabetic Retinopathy Study vision loss threshold of 10 letters. Stepwise backward logistic regression was used to analyze baseline factors associated with vision loss and to create a predictive algorithm. In the final regression model, the length of lapse in treatment (odds ratio [OR]; 1.15, 95% CI, 1.07-1.25), diabetic foot disease (OR, 3.02; 95% CI, 1.09-8.2), and Medicaid insurance (OR, 4.60; 95% CI, 1.20-18.7) were positively associated with vision loss ( .05). Time since diagnosis of diabetic retinopathy (OR, 0.95; 95% CI, 0.91-0.99) was negatively associated with vision loss ( .05). The final prediction model had a sensitivity of 20% and a specificity of 84%, with an area under the curve of 65%. For patients with DME at high risk for a lapse in treatment, baseline characteristics can help predict vision loss and guide management.
确定在接受玻璃体内抗血管内皮生长因子注射的糖尿病性黄斑水肿（DME）患者治疗中断后预测视力结果的基线特征。在这项回顾性研究中，治疗中断3个月或更长时间的DME患者根据早期糖尿病性视网膜病变研究中10个字母的视力丧失阈值被分为两组（视力稳定，n = 201；视力丧失，n = 61）。采用逐步向后逻辑回归分析与视力丧失相关的基线因素并创建预测算法。在最终回归模型中，治疗中断时长（比值比[OR]；1.15，95%可信区间[CI]，1.07 - 1.25）、糖尿病足病（OR，3.02；95% CI，1.09 - 8.2）和医疗补助保险（OR，4.60；95% CI，1.20 - 18.7）与视力丧失呈正相关（P < 0.05）。糖尿病性视网膜病变诊断后的时间（OR，0.95；95% CI，0.91 - 0.99）与视力丧失呈负相关（P < 0.05）。最终预测模型的敏感性为20%，特异性为84%，曲线下面积为65%。对于治疗中断风险高的DME患者，基线特征有助于预测视力丧失并指导管理。
