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Relevance of Visual Acuity Measurement for Therapeutic Decisions in Diabetic Macular Edema

This study aimed to determine the validity of basing retreatment decisions on anatomical criteria alone (captured using optical coherence tomography (OCT)—OCT-guided strategy) rather than the gold standard (combined visual acuity (VA) and OCT) in patients with diabetic macular edema (DME). This cros...

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Autores principales: Mathis, Thibaud, El Ameen, Batoul, Vartin, Cristina, Serrar, Yasmine, Matonti, Frédéric, Sudhalkar, Aditya, Bilgic, Alper, Rezkallah, Amina, Kodjikian, Laurent
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10303486/
https://www.ncbi.nlm.nih.gov/pubmed/37376056
http://dx.doi.org/10.3390/pharmaceutics15061607
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author Mathis, Thibaud
El Ameen, Batoul
Vartin, Cristina
Serrar, Yasmine
Matonti, Frédéric
Sudhalkar, Aditya
Bilgic, Alper
Rezkallah, Amina
Kodjikian, Laurent
author_facet Mathis, Thibaud
El Ameen, Batoul
Vartin, Cristina
Serrar, Yasmine
Matonti, Frédéric
Sudhalkar, Aditya
Bilgic, Alper
Rezkallah, Amina
Kodjikian, Laurent
author_sort Mathis, Thibaud
collection PubMed
description This study aimed to determine the validity of basing retreatment decisions on anatomical criteria alone (captured using optical coherence tomography (OCT)—OCT-guided strategy) rather than the gold standard (combined visual acuity (VA) and OCT) in patients with diabetic macular edema (DME). This cross-sectional study included 81 eyes undergoing treatment for DME from September 2021 to December 2021. An initial therapeutic treatment decision based on OCT results was made on inclusion. Subsequently, in light of the patient’s VA score, this initial decision was upheld or adjusted, and the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated. In 67 out of the 81 eyes included in the study (82.7%), the OCT-guided strategy produced equivalent results to the gold standard. In this study, the OCT-guided retreatment decision strategy yielded sensitivity and specificity of 92.3% and 73.8%, respectively, and PPV and NPV of 76.6% and 91.2%, respectively. These findings differed according to the patient’s treatment regimen: the sensitivity and specificity for eyes under a treat and extend regimen was higher, 100% and 88.9%, respectively, than eyes under a Pro Re Nata regimen, 90% and 69.7%, respectively. These findings show that VA testing could be omitted from the follow-up of certain patients with DME treated with intravitreal injections without impacting the quality of care.
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spelling pubmed-103034862023-06-29 Relevance of Visual Acuity Measurement for Therapeutic Decisions in Diabetic Macular Edema Mathis, Thibaud El Ameen, Batoul Vartin, Cristina Serrar, Yasmine Matonti, Frédéric Sudhalkar, Aditya Bilgic, Alper Rezkallah, Amina Kodjikian, Laurent Pharmaceutics Article This study aimed to determine the validity of basing retreatment decisions on anatomical criteria alone (captured using optical coherence tomography (OCT)—OCT-guided strategy) rather than the gold standard (combined visual acuity (VA) and OCT) in patients with diabetic macular edema (DME). This cross-sectional study included 81 eyes undergoing treatment for DME from September 2021 to December 2021. An initial therapeutic treatment decision based on OCT results was made on inclusion. Subsequently, in light of the patient’s VA score, this initial decision was upheld or adjusted, and the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated. In 67 out of the 81 eyes included in the study (82.7%), the OCT-guided strategy produced equivalent results to the gold standard. In this study, the OCT-guided retreatment decision strategy yielded sensitivity and specificity of 92.3% and 73.8%, respectively, and PPV and NPV of 76.6% and 91.2%, respectively. These findings differed according to the patient’s treatment regimen: the sensitivity and specificity for eyes under a treat and extend regimen was higher, 100% and 88.9%, respectively, than eyes under a Pro Re Nata regimen, 90% and 69.7%, respectively. These findings show that VA testing could be omitted from the follow-up of certain patients with DME treated with intravitreal injections without impacting the quality of care. MDPI 2023-05-29 /pmc/articles/PMC10303486/ /pubmed/37376056 http://dx.doi.org/10.3390/pharmaceutics15061607 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Mathis, Thibaud
El Ameen, Batoul
Vartin, Cristina
Serrar, Yasmine
Matonti, Frédéric
Sudhalkar, Aditya
Bilgic, Alper
Rezkallah, Amina
Kodjikian, Laurent
Relevance of Visual Acuity Measurement for Therapeutic Decisions in Diabetic Macular Edema
title Relevance of Visual Acuity Measurement for Therapeutic Decisions in Diabetic Macular Edema
title_full Relevance of Visual Acuity Measurement for Therapeutic Decisions in Diabetic Macular Edema
title_fullStr Relevance of Visual Acuity Measurement for Therapeutic Decisions in Diabetic Macular Edema
title_full_unstemmed Relevance of Visual Acuity Measurement for Therapeutic Decisions in Diabetic Macular Edema
title_short Relevance of Visual Acuity Measurement for Therapeutic Decisions in Diabetic Macular Edema
title_sort relevance of visual acuity measurement for therapeutic decisions in diabetic macular edema
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10303486/
https://www.ncbi.nlm.nih.gov/pubmed/37376056
http://dx.doi.org/10.3390/pharmaceutics15061607
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