Optical coherence tomography classifications of diabetic macular edema and response to aflibercept: One-year follow-up outcomes in a Chinese population.

To evaluate the effect of intravitreal aflibercept on different classifications of diabetic macular edema (DME) by spectral-domain optical coherence tomography. This hospital-based retrospective study included 95 consecutive patients (130 eyes) diagnosed with DME. Three groups were defined: diffuse retinal thickening (DRT), cystoid macular edema and serous retinal detachment. All eyes received intravitreal aflibercept (0.05 mL/2 mg) 5 times monthly. Best corrected visual acuity (BCVA) in (logarithm of the minimum angle of resolution) units and central macular thickness (CMT) on optical coherence tomography were recorded at months 1, 2, 3, 4, 6, and 12 after the injections. There was no significant baseline difference in BCVA (P = .273) or CMT (P = .115) among the 3 groups. Over 12 months, the BCVA of the DRT group significantly improved from baseline (P = .013). The BCVA of the cystoid macular edema (P = .062) and serous retinal detachment groups (P = .073) improved slightly from baseline. The DRT group had the greatest BCVA improvement (P = .021). Over 12 months, the CMTs of all 3 groups significantly decreased from baseline (P = .016, P = .025, P = .031). The CMT decreased more in the DRT group than in the other 2 groups (P = .009). The CMT changes were most evident in the DRT group (P = .022). Binary logistic regression analysis showed that DME type, disorganization of the retinal inner layers, ellipsoid zone disruption and external limiting membrane disruption independently predicted the effect of aflibercept treatment in DME patients (P = .006, P = .001, P = .004, P = .001). Aflibercept therapy improved anatomical structure and visual acuity in every type of DME; DRT responded best in terms of both BCVA and CMT. Furthermore, DME, disorganization of the retinal inner layers, external limiting membrane disruption and ellipsoid zone disruption independently predicted the effect of aflibercept treatment in DME patients.

Prevalence, Causes, and Risk Factors of Presenting Visual Impairment and Presenting Blindness in Adults Presenting to an Examination Center in Suzhou, China.

Purpose: To evaluate the prevalence, causes, and risk factors of presenting visual impairment (PVI) and presenting blindness among adults in Suzhou, China. Methods: A total of 43927 subjects were included in this cross-sectional study. Each subject underwent ophthalmic examinations, including presenting visual acuity (PVA), intraocular pressure (IOP), slit-lamp examination, and fundus examination under the small pupils of each eye. Results: Using the World Health Organization (WHO) definition, the prevalence of bilateral PVI, bilateral presenting blindness, monocular PVI, and monocular presenting blindness was 1.59% (95% CI, 1.51-1.67), 0.002% (95% CI, 0.0019-0.0021), 3.87% (95% CI, 3.68-4.06), and 0.19% (95% CI, 0.18-0.20), respectively. Using the United States (US) definition, the prevalence of bilateral PVI, bilateral presenting blindness, monocular PVI, and monocular presenting blindness was 5.83% (95% CI, 5.54-6.12), 0.04% (95% CI, 0.038-0.042), 7.43% (95% CI, 7.06-7.80), and 0.45% (95% CI, 0.43-0.47), respectively. The prevalence of PVI was higher in females (WHO criteria, 2.06%, 95% CI, 1.96-2.16; US criteria, 7.27%, 95% CI, 6.91-7.63) than in males (WHO criteria, 1.2%, 95 CI%, 1.14-1.26; US criteria, 4.65%, 95% CI, 4.42-4.89). The leading cause of PVI is an uncorrected refractive error, followed by cataracts and age-related macular degeneration (AMD). Multivariate analysis proved that the prevalence of visual impairment (PVA, better eye, WHO criteria) increased significantly with older age, higher mean arterial pressure (MAP), higher globulin level, and higher fasting blood glucose (FBG). In addition, it also increased significantly with lower hemoglobin, a lower body mass index (BMI), and a lower arterial stiffness index. In this study, serum creatinine, blood urea nitrogen, uric acid, triglycerides, and the systemic immune-inflammation index (SII) showed no association with visual impairment. Conclusion: The leading causes of PVI in Suzhou were uncorrected refractive error and cataracts. The prevalence of PVI increased with females, older age, higher MAP, higher FBG, higher globulin, lower hemoglobin, lower BMI, and lower arterial stiffness index.