On the relationship between visual acuity and central retinal (macular) thickness after interventions for macular oedema in diabetics: a review.
OBJECTIVE
The aim was to compare efficacy of treatments for diabetic macular oedema (DMO) from changes in visual acuity (VA) and central macular thickness (CMT).


METHODS
Peer-reviewed articles from 2004 to 2014 reporting intravitreal injections of bevacizumab (IVB), ranibizumab (IVR) or triamcinolone acetonide (IVTA) or laser photocoagulation therapy (LPT) provided data on pre-treatment (baseline) and final outcome measures. Net changes and relative changes (percentage) were assessed by linear regression analyses.


RESULTS
From 88 data sets the overall net change of VA was -0.10 ± 0.12 logMAR (mean ± standard deviation), being -0.13 ± 0.11 logMAR for IVB, 0 ± 0.08 logMAR for IVR and -0.12 ± 0.08 logMAR for IVTA as compared to 0.01 ± 0.14 logMAR for LPT. For CMT, the overall net change was -103 ± 71 microns, being -108 ± 64 microns for IVB, -182 ± 73 microns for IVR, and -102 ± 57 microns for IVTA and was -49 ± 60 microns for LPT. Overall, modest correlations were found between the absolute central retinal (macular) thickness change and the VA change, and the relative changes in these measures (p < 0.001, r = 0.522 or 0.457). The predicted visual outcome from a 100 microns reduction in CMT was -0.083 logMAR units, an effect not substantially influenced by the CMT measurement method.


CONCLUSIONS
Pharmacological treatment of DMO can be expected to result in a predictable decrease in CMT with an accompanying increase in VA, with the overall outcome being better than laser treatment.
Department of Vision Sciences, Glasgow-Caledonian University, Glasgow, UK.
Anna
A
Bong
Department of Vision Sciences, Glasgow-Caledonian University, Glasgow, UK. m.doughty@gcal.ac.uk.
Michael J
MJ
Doughty
Department of Vision Sciences, Glasgow-Caledonian University, Glasgow, UK.
Norman F
NF
Button
Ophthalmology Department, Inverclyde Royal Hospital, Greenock, UK.
David C
DC
Mansfield
D000068258:Bevacizumab / Q000008:administration & dosage; D003930:Diabetic Retinopathy / Q000628:therapy*; D006801:Humans; D016014:Linear Models; D008266:Macula Lutea / Q000473:pathology*; D008269:Macular Edema / Q000628:therapy*; D000069579:Ranibizumab / Q000008:administration & dosage; D041623:Tomography, Optical Coherence; D014222:Triamcinolone Acetonide / Q000008:administration & dosage; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors; D014792:Visual Acuity
D042461:Vascular Endothelial Growth Factor A; D000068258:Bevacizumab; D014222:Triamcinolone Acetonide; D000069579:Ranibizumab
anti-VEGF treatments; corticosteroid treatments; diabetes; diabetic macular oedema; laser photocoagulation