Comparison of Diabetic Macular Edema Treatment Patterns and Outcomes by European and US Retina-treating Ophthalmologists

AIM:To uncover and evaluate diabetic macular edema (DME) patient treatment patterns in the US and the largest EU countries.METHODS:Quantitative analyses of self-report data from retina-treating ophthalmologists via 30-minute Internet-based surveys. Data were collected across the US (one study) and EU (two studies— EU-1 and EU-2) between November 2011 and January 2013. Visual outcomes and rates of treatment success or failure were evaluated.RESULTS:Respondents were surveyed across the US (n=71) and EU (EU-1: n=180; EU-2: n=106). Nearly one-third of treated patients (US 38.6 %; EU-1 37.8 %; EU-2 30.7 %) reached a plateau in vision improvement. Geographical comparison showed no significant difference in responses between the US and the EU (EU-1, EU-2) (p>0.05).CONCLUSIONS:These data help to quantify the size of the chronic DME patient population in the US and EU, which is not achieving an acceptable functional outcome with current therapy. The paper provides solid empirical evidence regarding similarities in DME patient treatment and outcomes in the US and EU. The global and reproducible similarities in terms of physicians’ perceptions of the threshold of DME treatment burden and the visual outcomes when treatment benefit is limited are compelling. This is especially interesting within the present context where information regarding the effect of current treatments is limited. Diabetes is growing around the world at epidemic proportions, and these data provide insight into the impact DME may have on healthcare systems.

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The Impact of Baseline Retinal Volume on Visual Outcomes in the Treatment of Diabetic Macular Edema

Southern Clinics of Istanbul Eurasia ◽

10.14744/scie.2019.36854 ◽

2019 ◽

Author(s):

Mümin Hocaoğlu

Keyword(s):

Macular Edema ◽

Diabetic Macular Edema ◽

Visual Outcomes ◽

The Impact ◽

Retinal Volume

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Restoration of Foveal Bulge after Resolution of Diabetic Macular Edema with Coexisting Serous Retinal Detachment

Journal of Diabetes Research ◽

10.1155/2020/9705786 ◽

2020 ◽

Vol 2020 ◽

pp. 1-9

Author(s):

Yijun Hu ◽

Qiaowei Wu ◽

Baoyi Liu ◽

Manqing Huang ◽

Qingsheng Peng ◽

...

Keyword(s):

Visual Acuity ◽

Retinal Detachment ◽

Macular Edema ◽

Diabetic Macular Edema ◽

Outer Nuclear Layer ◽

Serous Retinal Detachment ◽

Foveal Thickness ◽

Central Foveal Thickness ◽

Significant Difference ◽

The Impact

Purpose. To evaluate the impact of restoration of foveal bulge (FB) in optical coherence tomography (OCT) images on visual acuity after resolution of diabetic macular edema with coexisting serous retinal detachment (SRD-DME). Methods. A total of 52 eyes with resolved SRD-DME and an intact ellipsoid zone at the central fovea were included. All eyes underwent best-corrected visual acuity (BCVA) examination and OCT scanning at baseline and follow-up visits (1, 3, and 6 months). The eyes were divided into two groups according to the presence of FB at 6 months. BCVA, central foveal thickness (CFT), height of SRD (SRDH), outer nuclear layer (ONL) thickness, photoreceptor inner segment (PIS), and outer segment (POS) length were compared between the two groups. Results. A FB was found in 25 of 52 (48%) eyes at 6 months. The FB (+) group had lower SRDH at baseline, and better BCVA, longer POS length at 6 months (all P<0.05). There was no significant difference in the CFT, ONL thickness, and PIS length at 6 months between the two groups (all P>0.05). More eyes in the FB (+) group had complete SRD resolution at 1 month (P=0.009) and 3 months (P=0.012). Eyes with complete SRD resolution at 1 month (P=0.009) or 3 months (P=0.012) were more likely to have a FB at 6 months. Conclusions. The Presence of the FB is associated with better BCVA after resolution of SRD-DME. Eyes with lower baseline SRDH or faster SRD resolution are more likely to have a FB at 6 months.

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Current Therapy of Diabetic Macular Edema Bevacizumab, Triamcinolone Acetonide, and Laser Photocoagulation

Ophthalmologica Indonesiana ◽

10.35749/journal.v45i1.172 ◽

2019 ◽

Vol 45 (1) ◽

pp. 13

Author(s):

Gladys Kusumowidagdo ◽

Randy Sarayar ◽

Kartika Rahayu ◽

Gitalisa Andayani

Keyword(s):

Macular Edema ◽

Triamcinolone Acetonide ◽

Diabetic Macular Edema ◽

Systematic Reviews ◽

Laser Photocoagulation ◽

Meta Analysis ◽

Intravitreal Bevacizumab ◽

Current Therapy ◽

Intravitreal Triamcinolone ◽

Mesh Terms

Background: Diabetic macular edema (DME) is the main cause of visual impairment in diabetic retinopathy (DR). Current gold standard therapy of DME is macular laser photocoagulation (MPC). Growing evidences have shown benefits of intravitreal anti-VEGF agents (i.e bevacizumab) and intravitreal corticosteroids (i.e triamcinolone acetonide). Aim: To compare the visual acuity (VA) improvement of patients with DME, treated with intravitreal bevacizumab (IVB), a combination of IVB and intravitreal triamcinolone (IVB/IVT), and MPC. Method: A comprehensive PubMed® and Cochrane® databases search was conducted on May 4th, 2017 using appropriate keywords (diabetic macular edema, bevacizumab, triamcinolone, and laser photocoagulation using their MeSH terms). Studies were filtered using inclusion criterions (clinical trials, RCT, meta-analysis, systematic review, English, humans, and publication within 10 years) Results: Three studies (2 systematic reviews and 1 RCT) were found suitable. From these results, all studies showed favoring effects of IVB when compared to IVB/IVT combination and MPC in short term period (up to 6 months). However, there was no significant improvement of VA beyond this period in all groups. Conclusion: IVB appears to be superior to IVB/IVT and MPC in improving VA during 6 months follow- up period. Future systematic reviews and meta-analysis are required on the effect of IVB and MPC combination in cases of DME.

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Psychoeducation as a strategy to improve family support perceived from patient with alcohol dependence and personality disorder

International journal of psychological research ◽

10.21500/20112084.745 ◽

2012 ◽

Vol 5 (1) ◽

pp. 18-24

Author(s):

José Miguel Martínez González ◽

Natalia Albein Urios ◽

Pilar Munera ◽

Antonio Verdejo García

Keyword(s):

Group Therapy ◽

Alcohol Dependence ◽

Personality Disorders ◽

Relapse Prevention ◽

Behavioral Therapy ◽

Individual Therapy ◽

Psychoeducational Intervention ◽

Self Report ◽

Significant Difference ◽

The Impact

The aim of this study was to prospectively analyze the impact of psychoeducation with relatives of addicted patients with personality disorders. We measured the impact of the psychoeducational intervention using a self-report questionnaire designed to assess perceived familiar support. The sample was composed by 37 patients with alcohol dependence following outpatient treatment. They underwent a cognitive-behavioral therapy relapse prevention program especially tailored for addicted individuals with comorbid personality disorders. 56.8% of patients followed individual therapy, and 43.2% followed group therapy. The relatives of the subgroup patients following group therapy simultaneously received the psychoeducational intervention. The analyses of the familiar support questionnaire across treatment showed a significant difference between groups as a function of treatment modality. Patients whose relatives followed the psychoeducational intervention had greater perception of familiar support throughout the treatment process.

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Aflibercept or ranibizumab for the treatment of diabetic macular edema; a retrospective study

International Journal of Research in Pharmaceutical Sciences ◽

10.26452/ijrps.v10i4.1586 ◽

2019 ◽

Vol 10 (4) ◽

pp. 3000-3005

Author(s):

Khlood M. Aldossary ◽

Anfal Alruzuq ◽

Ghady Almohanna ◽

Hessa Almusallam ◽

Sara Alamri ◽

...

Keyword(s):

Visual Acuity ◽

Macular Edema ◽

Diabetic Macular Edema ◽

Macular Thickness ◽

P Value ◽

Central Macular Thickness ◽

Intravitreal Ranibizumab ◽

Injectable Drugs ◽

Significant Difference ◽

Intravitreal Aflibercept

Diabetic macular edema (DME) is a significant cause of diabetic retinopathy and a major cause of vision loss. In this study, we aimed to evaluate and compare the efficacy of two injectable drugs; intravitreal Aflibercept and intravitreal Ranibizumab for the treatment of DME of the eyes. A retrospective chart review was conducted for patients diagnosed with DME from March 2014 to January 2019 who received either intravitreal Aflibercept or intravitreal Ranibizumab injection. A total of 57 eyes were included, of which 19 eyes were treated with intravitreal Ranibizumab injection, and 38 eyes were treated with intravitreal Aflibercept injection; all eyes were examined for 3 months. Two outcomes were assessed in this study, namely; visual acuity (VA) and central macular thickness (CMT). The mean age in the Ranibizumab group was 61.1±9.5 vs 64.3±10.2 in the Aflibercept group with no significant difference (p-value=0.25). The ratio of improvement in visual acuity (VA) in the Ranibizumab group was 68.4% vs 44.7% in the Aflibercept group; (p-value=0.038) which demonstrates the superiority of Ranibizumab over Aflibercept concerning visual acuity result. However, there is no statistically significant difference between the ratio of improvement in central macular thickness (CMT) results in both groups; (p-value=1.00). In fact, the ratio of improvement in CMT in both groups was the same 78.9% for both the groups. The pre and post results demonstrated improvement in post-procedural for CMT among both the groups but only Ranibizumab group showed VA improvement post-procedural. Through this study, we concluded that both injectable drugs improve visual acuity (VA) and decrease central macular thickness (CMT) in eyes with DME. However, Ranibizumab is superior in improving visual acuity compared to Aflibercept. Further comparative effectiveness trials between Aflibercept and Ranibizumab are still warranted.

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Impact of diabetes on caregiver stress in patients with Alzheimer's disease: data from the ICTUS study

International Psychogeriatrics ◽

10.1017/s1041610217002460 ◽

2018 ◽

Vol 30 (8) ◽

pp. 1109-1117 ◽

Cited By ~ 2

Author(s):

Jun Li ◽

Matteo Cesari ◽

Natalia Del Campo ◽

Sandrine Andrieu ◽

Birong Dong ◽

...

Keyword(s):

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Self Report ◽

Personal Life ◽

Diabetic Patients ◽

Psychological Burden ◽

Factorial Model ◽

The Social ◽

Significant Difference ◽

The Impact

ABSTRACTBackground:To estimate the impact of comorbid diabetes on caregiver stress in Alzheimer's disease (AD) patients from the Impact of Cholinergic Treatment Use (ICTUS) study.Methods:Using the Data from the ICTUS study, diabetes mellitus (DM) was recorded at baseline and caregiver burden was assessed twice per year using the Zarit Burden Interview (ZBI) scale. The three-factorial model of ZBI (the effect on the social and personal life of caregivers, the psychological burden and the feelings of guilt) was adopted. Linear mixed models were used to examine the relation between DM and the scores of ZBI.Results:The present analyses were conducted on 1,264 AD subjects. A total of 156 patients (12.3%) had DM with taking antidiabetic medication and/or self-report of a history. At baseline, the caregivers of patients with or without DM had similar ZBI global scores and similar scores of three different factors of ZBI. Unadjusted and adjusted models both indicated that ZBI global score increased over a 24-month follow-up without significant effect of DM. Similarly, unadjusted model showed that DM was not determining any significant difference in the score of any factor. However, adjusted model indicated that in diabetic patients, the scores of the social and personal life of caregivers and the psychological burden increased more slowly than those in non-diabetic patients (p = 0.04 and 0.01, respectively).Conclusions:DM may affect the caregivers’ daily social and personal life and psychological burden in AD patients. It is necessary for further research.

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