Visual Outcomes in the Management of Diabetic Maculopathy in Central Australia

Pavani Kurra, Laima Brazionis, Jesse Gale, Katie Chen, Stewart Lake, Kristy P. Robledo, Tim Henderson

    Research output: Contribution to journalArticle

    1 Citation (Scopus)

    Abstract

    Purpose: In major urban centres and high-resource settings, treatment of diabetic maculopathy with anti-Vascular Endothelial Growth Factor (VEGF) injections has largely displaced laser treatment. However, intravitreal therapy alone requires frequent follow-up, a barrier to adherence in remote Australia. We report vision outcomes of phased diabetic maculopathy treatment in remote Central Australia for maculopathy using laser and, in a subset, supplementary injection treatment. Methods: We audited clinical records of patients undergoing laser treatment for diabetic maculopathy between 2001 and 2013 at an ophthalmology service based at Alice Springs Hospital, a regional hub in remote Australia. All patients receiving macular laser treatment were included, and some required supplementary injection(s). The primary outcome measure was change in best-corrected visual acuity [BCVA] from baseline treatment. Results: Of 338 maculopathy-treated patients, 88% were indigenous and 39% were male. Of 554 maculopathy laser-treated eyes, 118 (21%) received supplementary injection/s. In the laser treatment phase, median BCVA was 78 letters at baseline (interquartile range 62–80) and decreased by a median of two letters at final visit. In the subset who underwent subsequentinjection treatment, BCVA was 60 letters at first injection, with a median five-letter increase by final visit. Overall outcomes were similar in Indigenous and non-Indigenous Australians. Predictors of reduction in BCVA in the macular laser treatment phase were better baseline BCVA, older age, and PRP treatment (all p < .005). Conclusion: Laser treatment for diabetic maculopathy preserved vision in Central Australia, where barriers to follow-up can preclude regular injections. Supplementary injections stabilized vision in the laser-resistant subset.

    Original languageEnglish
    Pages (from-to)265-271
    Number of pages7
    JournalOphthalmic Epidemiology
    Volume27
    Issue number4
    DOIs
    Publication statusPublished - 2020

    Keywords

    • Anti-VEGF injections
    • Avastin
    • Bevacizumab
    • diabetic maculopathy
    • diabetic retinopathy
    • laser photocoagulation

    Fingerprint Dive into the research topics of 'Visual Outcomes in the Management of Diabetic Maculopathy in Central Australia'. Together they form a unique fingerprint.

  • Cite this

    Kurra, P., Brazionis, L., Gale, J., Chen, K., Lake, S., Robledo, K. P., & Henderson, T. (2020). Visual Outcomes in the Management of Diabetic Maculopathy in Central Australia. Ophthalmic Epidemiology, 27(4), 265-271. https://doi.org/10.1080/09286586.2020.1730909