[French practice patterns in the management of diabetic macular edema].
OBJECTIVE
To assess French practice patterns in the treatment of diabetic macular edema (DME).


METHODS
A 31-item survey investigating practice patterns in the diagnosis and management of DME was e-mailed in March 2015 to retina specialist members of the French-speaking Retina Specialist Society. During this time frame, only ranibizumab was reimbursed for this indication. For each question concerning the choice of treatments, respondents were asked to assume that all treatments having market approval were also reimbursed. Answers were analyzed anonymously by Evalandgo software.


RESULTS
Ninety-five specialists answered the survey. Two thirds of them initiated an intravitreal treatment for DME for a loss of vision greater than 0.5 (Monoyer scale). The three determining factors for treatment choice were potential VA improvement, expected retinal anatomic improvement, and patient availability for monthly follow-up. For central DME in phakic or pseudophakic eyes, the first choice of intravitreal (IVT) treatment was ranibizumab, even assuming that all drugs approved by French authorities (HAS) were reimbursed by the health care system. Eighty-five percent of retinal specialists propose bilateral intravitreal injections the same day for the same patient.


CONCLUSIONS
Most of the specialists initiate DME treatment for a VA>0.5 in France. Eighty-five percent of them perform bilateral intravitreal injections on the same day in the case of bilateral DME.
Service d'ophtalmologie, DHU vision and handicaps, hôpital CHU Avicenne, 125, rue de Stalingrad, 93000 Bobigny, France.
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Qu-Knafo
Service d'ophtalmologie, DHU vision and handicaps, hôpital CHU Avicenne, 125, rue de Stalingrad, 93000 Bobigny, France; Centre ophtalmologique d'imagerie et de laser, 11, rue Antoine-Bourdelle, 75015 Paris, France.
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Fajnkuchen
Service d'ophtalmologie, DHU vision and handicaps, hôpital CHU Avicenne, 125, rue de Stalingrad, 93000 Bobigny, France.
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Sarda
Service d'ophtalmologie, DHU vision and handicaps, hôpital CHU Avicenne, 125, rue de Stalingrad, 93000 Bobigny, France; Centre ophtalmologique d'imagerie et de laser, 11, rue Antoine-Bourdelle, 75015 Paris, France.
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Nghiem-Buffet
Service d'ophtalmologie, DHU vision and handicaps, hôpital CHU Avicenne, 125, rue de Stalingrad, 93000 Bobigny, France.
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Chaine
Service d'ophtalmologie, DHU vision and handicaps, hôpital CHU Avicenne, 125, rue de Stalingrad, 93000 Bobigny, France. Electronic address: audreygiocanti@yahoo.fr.
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Giocanti-Auregan
D020533:Angiogenesis Inhibitors / Q000008:administration & dosage; D003907:Dexamethasone / Q000008:administration & dosage; D003930:Diabetic Retinopathy / Q000453:epidemiology / Q000628:therapy*; D005446:Fluocinolone Acetonide / Q000008:administration & dosage / Q000031:analogs & derivatives; D005602:France / Q000453:epidemiology; D006801:Humans; D058449:Intravitreal Injections; D008269:Macular Edema / Q000453:epidemiology / Q000628:therapy; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D000069579:Ranibizumab / Q000008:administration & dosage; D011795:Surveys and Questionnaires; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors
D020533:Angiogenesis Inhibitors; D042461:Vascular Endothelial Growth Factor A; D005446:Fluocinolone Acetonide; D003907:Dexamethasone; C035394:fluocinolone; D000069579:Ranibizumab
Anti-VEGF; Dexamethasone; Dexaméthasone; Diabetic macular edema; Fluocinolone; Practice patterns; Évaluation des pratiques; Œdème maculaire diabétique