Atrophy of the Central Neuroretina

PURPOSE

• To examine the prevalence of central retinal atrophy in patients treated for diabetic macular edema (DME) in a clinical setting.
• Retrospective data analysis of patients with DME, focusing on those who developed central retinal thinning after DME treatment at the Department of Ophthalmology, Medical University Vienna

STUDY

• A total of 6684 outpatient visits by 1437 patients with diabetes were analysed. Out of 149 patients, who had had a central subfield thickness (CST) below 200 μm, 32 (36 eyes) had previously been diagnosed with a centre involving DME with an average CST of 473 ± 103 μm and average visual acuity of 0.62 ± 0.44 logMAR at first presentation.
• At the time of central atrophy, 29 (81%) out of 36 eyes had a history of laser treatment, 11 (31%) a vitrectomy, 32 (88%) repeated intravitreal injections of anti-vascular endothelial growth factor (VEGF; mean 5.3 ± 3.8) and 22 (61%) intravitreal corticosteroid injections (mean 2.5 ± 2.7).
• Visual function (0.67 ± 0.43 logMAR) at the time of atrophy was not significantly correlated to central retinal thickness (191 ± 7 μm) or any other ocular, systemic or treatment factors.

CONCLUSIONS

• Only 4% of patients treated for DME developed central retinal thinning in above study

 TAKE HOME MESSAGE

• This retrospective study estimated the prevalence of central retinal atrophy among patients with diabetic macular edema (DME). During the study period between 2012 and 2016, central retinal thinning was observed in 4% of the 1437 diabetic patients analyzed. Additionally, central retinal atrophy could not be attributed to anti-VEGF therapy in these patients.
• The predictors for central retinal atrophy included a greater degree of central subfield thickness and lower best-corrected visual acuity at the first presentation of DME.

REFERENCE

Acta Ophthalmol 2019 Jun 22;[EPub Ahead of Print], SG Karst, M Schuster, C Mitsch, EL Meyer, M Kundi, C Scholda, UM Schmidt-Erfurth