Factors Influencing Treatment of Diabetic Macular Edema

New data from the American Society of Retina Specialists (ASRS) 2021 Scientific Meeting this weekend bucked clinicians’ perspectives of what baseline factors influence a patients’ treatment of diabetic macular edema (DME).

The new findings from the 2-year VISTA and VIVID trials, presented by Rishi P. Singh, MD, of the Cole Eye Institute at the Cleveland Clinic, observed baseline patient characteristics and vision-related factors and their association with treatment of DME with intravitreal aflibercept injection.Singh and colleagues observed that thicker central subfield thickness (CST) and above-average best corrected visual acuity (BCVA) at baseline were associated with greater time to DME resolution—as well as a lower rate of resolution overall.

In an interview with HCPLive during ASRS 2021, Singh highlighted the observed “disconnect between anatomy and vision” observed in patients with DME from VISTA/VIVID, as well as some of the debunked preconceptions he and colleagues had about DME treatment-mitigating risk factors.

“One of the hypotheses that we had going into the study was that worse diabetic retinopathy severity potentially had a longer time to DME resolution—and in fact, we didn’t see that relationship,” Singh said. “We didn’t see a relationship with hemoglobin in A1c, so diabetes control (and DME).”

Singh also discussed the significance of the findings on general ophthalmology prescribing and patient follow-up.

“I think as a whole in the total study, it really helps people understand the duration of treatment needed to get to a good, steady state, and it allows clinicians to understand the needs of the patients depending on where they sit in the baseline factors,” Singh said.