Treatment of diabetic macular edema in real‐world clinical practice: The effect of aging
ABSTRACT 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 clinic...
| Main Authors: | , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wiley
2022-08-01
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| Series: | Journal of Diabetes Investigation |
| Subjects: | |
| Online Access: | https://doi.org/10.1111/jdi.13801 |
| _version_ | 1818179321666207744 |
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| author | Sentaro Kusuhara Masahiko Shimura Shigehiko Kitano Masahiko Sugimoto Daisuke Muramatsu Harumi Fukushima Yoshihiro Takamura Makiko Matsumoto Masahide Kokado Jiro Kogo Mariko Sasaki Yuki Morizane Takuya Utsumi Osamu Kotake Takashi Koto Hiroto Terasaki Takao Hirano Hiroto Ishikawa Yoshinori Mitamura Fumiki Okamoto Takamasa Kinoshita Kazuhiro Kimura Kenji Yamashiro Yukihiko Suzuki Taiichi Hikichi Noriaki Washio Tomohito Sato Kishiko Ohkoshi Hiroki Tsujinaka Mineo Kondo Hitoshi Takagi Toshinori Murata Taiji Sakamoto Japan Clinical Retina Study (J‐CREST) group |
| author_facet | Sentaro Kusuhara Masahiko Shimura Shigehiko Kitano Masahiko Sugimoto Daisuke Muramatsu Harumi Fukushima Yoshihiro Takamura Makiko Matsumoto Masahide Kokado Jiro Kogo Mariko Sasaki Yuki Morizane Takuya Utsumi Osamu Kotake Takashi Koto Hiroto Terasaki Takao Hirano Hiroto Ishikawa Yoshinori Mitamura Fumiki Okamoto Takamasa Kinoshita Kazuhiro Kimura Kenji Yamashiro Yukihiko Suzuki Taiichi Hikichi Noriaki Washio Tomohito Sato Kishiko Ohkoshi Hiroki Tsujinaka Mineo Kondo Hitoshi Takagi Toshinori Murata Taiji Sakamoto Japan Clinical Retina Study (J‐CREST) group |
| author_sort | Sentaro Kusuhara |
| collection | DOAJ |
| description | ABSTRACT 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, <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 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. |
| first_indexed | 2024-12-11T21:02:01Z |
| format | Article |
| id | doaj.art-89b705ed028e4ecdb9df13da159a4d96 |
| institution | Directory Open Access Journal |
| issn | 2040-1116 2040-1124 |
| language | English |
| last_indexed | 2024-12-11T21:02:01Z |
| publishDate | 2022-08-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of Diabetes Investigation |
| spelling | doaj.art-89b705ed028e4ecdb9df13da159a4d962022-12-22T00:50:58ZengWileyJournal of Diabetes Investigation2040-11162040-11242022-08-011381339134610.1111/jdi.13801Treatment of diabetic macular edema in real‐world clinical practice: The effect of agingSentaro Kusuhara0Masahiko Shimura1Shigehiko Kitano2Masahiko Sugimoto3Daisuke Muramatsu4Harumi Fukushima5Yoshihiro Takamura6Makiko Matsumoto7Masahide Kokado8Jiro Kogo9Mariko Sasaki10Yuki Morizane11Takuya Utsumi12Osamu Kotake13Takashi Koto14Hiroto Terasaki15Takao Hirano16Hiroto Ishikawa17Yoshinori Mitamura18Fumiki Okamoto19Takamasa Kinoshita20Kazuhiro Kimura21Kenji Yamashiro22Yukihiko Suzuki23Taiichi Hikichi24Noriaki Washio25Tomohito Sato26Kishiko Ohkoshi27Hiroki Tsujinaka28Mineo Kondo29Hitoshi Takagi30Toshinori Murata31Taiji Sakamoto32Japan Clinical Retina Study (J‐CREST) groupDivision of Ophthalmology, Department of Surgery Kobe University Graduate School of Medicine Kobe JapanDepartment of Ophthalmology Tokyo Medical University Hachioji Medical Center Hachioji JapanDepartment of Ophthalmology, Diabetes Center Tokyo Women's Medical University Tokyo JapanDepartment of Ophthalmology Mie University Graduate School of Medicine Tsu JapanDepartment of Ophthalmology Tokyo Medical University Tokyo JapanDepartment of Ophthalmology, Diabetes Center Tokyo Women's Medical University Tokyo JapanDepartment of Ophthalmology, School of Medical Sciences University of Fukui Yoshida JapanDepartment of Ophthalmology and Visual Sciences, Graduate School of Biomedical, Sciences Nagasaki University Nagasaki JapanDepartment of Ophthalmology Wakayama Medical University Wakayama JapanDepartment of Ophthalmology St. Marianna University School of Medicine Kawasaki JapanDepartment of Ophthalmology Tachikawa Hospital Tachikawa JapanDepartment of Ophthalmology Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Okayama JapanDepartment of Ophthalmology Tokyo Medical University Hachioji Medical Center Hachioji JapanDepartment of Ophthalmology Tokyo Medical University Tokyo JapanKyorin Eye Center Kyorin University School of Medicine Mitaka JapanDepartment of Ophthalmology Kagoshima University Graduate School of Medical and Dental Sciences Kagoshima JapanDeparment of Ophthalmology Shinshu University School of Medicine Matsumoto JapanDepartment of Ophthalmology Hyogo College of Medicine Nishinomiya JapanDepartment of Ophthalmology, Institute of Health Biosciences The University of Tokushima Graduate School Tokushima JapanDepartment of Ophthalmology, Faculty of Medicine University of Tsukuba Tsukuba JapanDepartment of Ophthalmology Sapporo City General Hospital Sapporo JapanDepartmet of Ophthalmology Yamaguchi University Graduate School of Medicine Ube JapanDepartment of Ophthalmology Japanese Red Cross Otsu Hospital Otsu JapanDepartment of Ophthalmology Hirosaki University Graduate School of Medicine Hirosaki JapanHikichi Eye Clinic Sapporo JapanDepartment of Ophthalmology Showa General Hospital Kodaira JapanDepartment of Ophthalmology National Defense Medical College Tokorozawa JapanDepartment of Ophthalmology St. Luke's International Hospital Tokyo JapanDepartment of Ophthalmology Nara Medical University Graduate School of Medicine Kashihara JapanDepartment of Ophthalmology Mie University Graduate School of Medicine Tsu JapanDepartment of Ophthalmology St. Marianna University School of Medicine Kawasaki JapanDeparment of Ophthalmology Shinshu University School of Medicine Matsumoto JapanDepartment of Ophthalmology Kagoshima University Graduate School of Medical and Dental Sciences Kagoshima JapanABSTRACT 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, <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 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.https://doi.org/10.1111/jdi.13801AgingDiabetesDiabetic macular edema |
| spellingShingle | Sentaro Kusuhara Masahiko Shimura Shigehiko Kitano Masahiko Sugimoto Daisuke Muramatsu Harumi Fukushima Yoshihiro Takamura Makiko Matsumoto Masahide Kokado Jiro Kogo Mariko Sasaki Yuki Morizane Takuya Utsumi Osamu Kotake Takashi Koto Hiroto Terasaki Takao Hirano Hiroto Ishikawa Yoshinori Mitamura Fumiki Okamoto Takamasa Kinoshita Kazuhiro Kimura Kenji Yamashiro Yukihiko Suzuki Taiichi Hikichi Noriaki Washio Tomohito Sato Kishiko Ohkoshi Hiroki Tsujinaka Mineo Kondo Hitoshi Takagi Toshinori Murata Taiji Sakamoto Japan Clinical Retina Study (J‐CREST) group Treatment of diabetic macular edema in real‐world clinical practice: The effect of aging Journal of Diabetes Investigation Aging Diabetes Diabetic macular edema |
| title | Treatment of diabetic macular edema in real‐world clinical practice: The effect of aging |
| title_full | Treatment of diabetic macular edema in real‐world clinical practice: The effect of aging |
| title_fullStr | Treatment of diabetic macular edema in real‐world clinical practice: The effect of aging |
| title_full_unstemmed | Treatment of diabetic macular edema in real‐world clinical practice: The effect of aging |
| title_short | Treatment of diabetic macular edema in real‐world clinical practice: The effect of aging |
| title_sort | treatment of diabetic macular edema in real world clinical practice the effect of aging |
| topic | Aging Diabetes Diabetic macular edema |
| url | https://doi.org/10.1111/jdi.13801 |
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