title: CLINICAL EVIDENCE OF THE MULTIFACTORIAL NATURE OF DIABETIC MACULAR EDEMA.
abstract: OBJECTIVE
  To report functional and morphologic outcomes, based on diabetic macular edema (DME) chronicity and baseline best-corrected visual acuity (BCVA), from a subanalysis of the fluocinolone acetonide for macular edema (FAME) trials.
  
  
  METHODS
  Patients were categorized by DME duration (nonchronic [ncDME] or chronic [cDME] DME) and three nonexclusive baseline vision strata. Anatomic and visual acuity VA outcomes of these cohorts were compared with treatment assignment.
  
  
  RESULTS
  For all patients with ncDME and cDME who received sham control, 27.8% and 13.4%, respectively, gained ≥15 BCVA letters, whereas 22.3% and 34.0% of 0.2 μg/day fluocinolone acetonide (FAc)-treated patients, respectively, gained ≥15 BCVA letters. Among patients with ncDME who received sham control, as baseline vision decreased, the percentage gaining ≥15 BCVA letters increased; however, among those with cDME, the percentage gaining ≥15 BCVA letters did not change as baseline vision decreased. Conversely, among 0.2 μg/day FAc-treated patients, the percentage gaining ≥15 BCVA letters increased with decreasing baseline vision, regardless of DME chronicity. Anatomical outcomes were similar within treatment arms, regardless of the DME duration.
  
  
  CONCLUSIONS
  Patients with cDME and poor baseline vision who were exposed to low-dose FAc experienced BCVA improvements that were not observed in a similar group from the sham-control arm. These data support the multifactorial pathogenesis of cDME.
authors.affiliation: School of Medicine, Dentistry, and Biomedical Sciences, The Queen's University of Belfast, Belfast, United Kingdom.
authors.forename: Usha
authors.initials: U
authors.lastname: Chakravarthy
authors.affiliation: Royal Wolverhampton Hospitals NHS Trust, Wolverhampton, United Kingdom.
authors.forename: Yit
authors.initials: Y
authors.lastname: Yang
authors.affiliation: Clinical and Experimental Sciences, University of Southampton, Southampton, England.
authors.forename: Andrew
authors.initials: A
authors.lastname: Lotery
authors.affiliation: Bradford Teaching Hospitals NHS Foundation Trust, Bradford, United Kingdom.
authors.forename: Faruque
authors.initials: F
authors.lastname: Ghanchi
authors.affiliation: School of clinical Sciences, Research and Treatment Unit at Bristol Eye Hospital, University of Bristol, Bristol, United Kingdom.
authors.forename: Clare
authors.initials: C
authors.lastname: Bailey
authors.affiliation: Department of Ophthalmology, University of Bonn, Bonn, Germany.
authors.forename: Frank G
authors.initials: FG
authors.lastname: Holz
authors.affiliation: Hull and East Yorkshire Eye Hospital NHS Trust, Hull, United Kingdom.
authors.forename: Louise
authors.initials: L
authors.lastname: Downey
authors.affiliation: Department of Ophthalmology, University of Nantes, Nantes, France.
authors.forename: Michel
authors.initials: M
authors.lastname: Weber
authors.affiliation: Department of Ophthalmology, University of Muenster Medical Center, Muenster, Germany.
authors.forename: Nicole
authors.initials: N
authors.lastname: Eter
authors.affiliation: Retinal Consultants of Arizona, Phoenix, Arizona and USC Roski Eye Institute, Keck School of Medicine, University of Southern California, Los Angeles, California.
authors.forename: Pravin U
authors.initials: PU
authors.lastname: Dugel
mesh_terms: D000368:Aged; D020533:Angiogenesis Inhibitors / Q000008:administration & dosage*; D003930:Diabetic Retinopathy / Q000150:complications / Q000175:diagnosis / Q000628:therapy*; D004311:Double-Blind Method; D004343:Drug Implants; D005260:Female; D005446:Fluocinolone Acetonide / Q000008:administration & dosage*; D005938:Glucocorticoids / Q000008:administration & dosage*; D006801:Humans; D058449:Intravitreal Injections; D017075:Laser Coagulation / Q000379:methods*; D008269:Macular Edema / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D041623:Tomography, Optical Coherence; D016896:Treatment Outcome; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors*; D014792:Visual Acuity
chemical_list: D020533:Angiogenesis Inhibitors; D004343:Drug Implants; D005938:Glucocorticoids; D042461:Vascular Endothelial Growth Factor A; D005446:Fluocinolone Acetonide