Treatment of diabetic macular edema in real-world clinical practice: The effect of aging

被引：3

作者：

Kusuhara, Sentaro ^{[1
]}

Shimura, Masahiko ^{[2
]}

Kitano, Shigehiko ^{[3
]}

Sugimoto, Masahiko ^{[4
]}

Muramatsu, Daisuke ^{[5
]}

Fukushima, Harumi ^{[3
]}

Takamura, Yoshihiro ^{[6
]}

Matsumoto, Makiko ^{[7
]}

Kokado, Masahide ^{[8
]}

Kogo, Jiro ^{[9
]}

Sasaki, Mariko ^{[10
,11
]}

Morizane, Yuki ^{[12
]}

Utsumi, Takuya ^{[2
]}

Kotake, Osamu ^{[5
]}

Koto, Takashi ^{[13
]}

Terasaki, Hiroto ^{[14
]}

Hirano, Takao ^{[15
]}

Ishikawa, Hiroto ^{[16
]}

Mitamura, Yoshinori ^{[17
]}

Okamoto, Fumiki ^{[18
]}

Kinoshita, Takamasa ^{[19
]}

Kimura, Kazuhiro ^{[20
]}

Yamashiro, Kenji ^{[21
]}

Suzuki, Yukihiko ^{[22
]}

Hikichi, Taiichi ^{[23
]}

Washio, Noriaki ^{[24
]}

Sato, Tomohito ^{[25
]}

Ohkoshi, Kishiko ^{[26
]}

Tsujinaka, Hiroki ^{[27
]}

Kondo, Mineo ^{[4
]}

Takagi, Hitoshi ^{[9
]}

Murata, Toshinori ^{[15
]}

Sakamoto, Taiji ^{[14
]}

机构：

[1] Kobe Univ, Dept Surg, Div Ophthalmol, Grad Sch Med, Kobe, Hyogo, Japan

[2] Tokyo Med Univ, Dept Ophthalmol, Hachioji Med Ctr, Hachioji, Tokyo, Japan

[3] Tokyo Womens Med Univ, Diabet Ctr, Dept Ophthalmol, Tokyo, Japan

[4] Mie Univ, Dept Ophthalmol, Grad Sch Med, Tsu, Mie, Japan

[5] Tokyo Med Univ, Dept Ophthalmol, Tokyo, Japan

[6] Univ Fukui, Sch Med Sci, Dept Ophthalmol, Yoshida, Japan

[7] Nagasaki Univ, Grad Sch Biomed Sci, Dept Ophthalmol & Visual Sci, Nagasaki, Japan

[8] Wakayama Med Univ, Dept Ophthalmol, Wakayama, Japan

[9] St Marianna Univ, Sch Med, Dept Ophthalmol, Kawasaki, Kanagawa, Japan

[10] Tachikawa Hosp, Dept Ophthalmol, Tachikawa, Tokyo, Japan

[11] Natl Hosp Org Tokyo Med Ctr, Dept Ophthalmol, Meguro Ku, Tokyo, Japan

[12] Okayama Univ, Grad Sch Med Dent & Pharmaceut Sci, Dept Ophthalmol, Okayama, Japan

[13] Kyorin Univ, Kyorin Eye Ctr, Sch Med, Mitaka, Tokyo, Japan

[14] Kagoshima Univ, Dept Ophthalmol, Grad Sch Med & Dent Sci, Kagoshima, Japan

[15] Shinshu Univ, Dept Ophthalmol, Sch Med, Matsumoto, Nagano, Japan

[16] Hyogo Coll Med, Dept Ophthalmol, Nishinomiya, Hyogo, Japan

[17] Univ Tokushima, Inst Hlth Biosci, Dept Ophthalmol, Grad Sch, Tokushima, Japan

[18] Univ Tsukuba, Fac Med, Dept Ophthalmol, Tsukuba, Ibaraki, Japan

[19] Sapporo City Gen Hosp, Dept Ophthalmol, Sapporo, Hokkaido, Japan

[20] Yamaguchi Univ, Dept Ophthalmol, Grad Sch Med, Ube, Yamaguchi, Japan

[21] Japanese Red Cross Otsu Hosp, Dept Ophthalmol, Otsu, Shiga, Japan

[22] Hirosaki Univ, Dept Ophthalmol, Grad Sch Med, Hirosaki, Aomori, Japan

[23] Hikichi Eye Clin, Sapporo, Hokkaido, Japan

[24] Showa Gen Hosp, Dept Ophthalmol, Kodaira, Tokyo, Japan

[25] Natl Def Med Coll, Dept Ophthalmol, Tokorozawa, Saitama, Japan

[26] St Lukes Int Hosp, Dept Ophthalmol, Tokyo, Japan

[27] Nara Med Univ, Dept Ophthalmol, Grad Sch Med, Kashihara, Nara, Japan

来源：

JOURNAL OF DIABETES INVESTIGATION | 2022年 / 13卷 / 08期

关键词：

Aging; Diabetes; Diabetic macular edema; RANIBIZUMAB; COMPLICATIONS; MELLITUS; OUTCOMES; RESTORE;

D O I：

10.1111/jdi.13801

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Aims/Introduction In older patients, the management of diabetic macular edema (DME) can be complicated by comorbidities, geriatric syndrome, and socioeconomic status. This study aims to evaluate the effects of aging on the management of DME. Materials and Methods This is a real-world clinical study including 1,552 patients with treatment-naive center-involved DME. The patients were categorized into 4 categories by age at baseline (C1, <55; C2, 55-64; C3, 65-74; and C4, >= 75 years). The outcomes were the change in logarithm of the minimum angle of resolution best-corrected visual acuity (logMAR BCVA) and central retinal thickness (CRT), and the number of treatments from baseline to 2 years. Results From baseline to 2 years, the mean changes in logMAR BCVA from baseline to 2 years were -0.01 in C1, -0.06 in C2, -0.07 in C3, and 0.01 in C4 (P = 0.016), and the mean changes in CRT were -136.2 mu m in C1, -108.8 mu m in C2, -100.6 mu m in C3, and -89.5 mu m in C4 (P = 0.008). Treatments applied in the 2 year period exhibited decreasing trends with increasing age category on the number of intravitreal injections of anti-VEGF agents (P = 0.06), selecting local corticosteroid injection (P = 0.031), vitrectomy (P < 0.001), and laser photocoagulation outside the great vascular arcade (P < 0.001). Conclusions Compared with younger patients with DME, patients with DME aged >= 75 years showed less frequent treatment, a lower BCVA gain, and a smaller CRT decrease. The management and visual outcome in older patients with DME would be unsatisfactory in real-world clinical practice.

引用

页码：1339 / 1346

页数：8

共 23 条

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