학술논문
Treatment of diabetic macular edema in real‐world clinical practice: The effect of aging
Document Type
Clinical report
Author
Kusuhara, Sentaro; Shimura, Masahiko; Kitano, Shigehiko; Sugimoto, Masahiko; Muramatsu, Daisuke; Fukushima, Harumi; Takamura, Yoshihiro; Matsumoto, Makiko; Kokado, Masahide; Kogo, Jiro; Sasaki, Mariko; Morizane, Yuki; Utsumi, Takuya; Kotake, Osamu; Koto, Takashi; Terasaki, Hiroto; Hirano, Takao; Ishikawa, Hiroto; Mitamura, Yoshinori; Okamoto, Fumiki; Kinoshita, Takamasa; Kimura, Kazuhiro; Yamashiro, Kenji; Suzuki, Yukihiko; Hikichi, Taiichi; Washio, Noriaki; Sato, Tomohito; Ohkoshi, Kishiko; Tsujinaka, Hiroki; Kondo, Mineo; Takagi, Hitoshi; Murata, Toshinori; Sakamoto, Taiji
Source
Journal of Cutaneous Immunology and Allergy. August 2022, Vol. 13 Issue 8, p1339, 1346 p.
Subject
Language
English
Abstract
INTRODUCTION According to a report from the United Nations, approximately 700 million persons worldwide were aged ≥65 years in 2019, and the percentage of the population aged ≥65 years was [...]
: 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‐naïve center‐involved DME. The patients were categorized into 4 categories by age at baseline (C1, 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 μm in C1, −108.8 μm in C2, −100.6 μm in C3, and −89.5 μm 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.
: 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‐naïve center‐involved DME. The patients were categorized into 4 categories by age at baseline (C1, 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 μm in C1, −108.8 μm in C2, −100.6 μm in C3, and −89.5 μm 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.