Enhancing Diabetic Macular Edema Treatment Outcomes: Exploring the ESASO Classification and Structural OCT Biomarkers

Introduction This study assessed the European School of Advanced Studies in Ophthalmology (ESASO) classification’s prognostic value for diabetic macular edema (DME) in predicting intravitreal therapy outcomes. Methods In this retrospective, multicenter study, patients aged > 50 years with type 1...

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Bibliographic Details
Published in:Ophthalmology and therapy 2024-05, Vol.13 (5), p.1383-1398
Main Authors: Panozzo, Giacomo, Cicinelli, Maria V., Dalla Mura, Giulia, Giannarelli, Diana, Vadalà, Maria, Bonfiglio, Vincenza, Bellisario, Giovanni, Bandello, Francesco
Format: Article
Language:English
Subjects:
Anti-VEGF
Diabetic macular edema
ESASO classification
Internal Medicine
Medicine
Medicine & Public Health
OCT Biomarkers
Ophthalmology
Optical coherence tomography
Original Research
Steroid
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Summary:Introduction This study assessed the European School of Advanced Studies in Ophthalmology (ESASO) classification’s prognostic value for diabetic macular edema (DME) in predicting intravitreal therapy outcomes. Methods In this retrospective, multicenter study, patients aged > 50 years with type 1 or 2 diabetes and DME received intravitreal antivascular endothelial growth factor (anti-VEGF) agents (ranibizumab, bevacizumab, and aflibercept) or steroids (dexamethasone). The primary outcome was visual acuity (VA) change post-treatment, termed as functional response, measured 4–6 weeks post-third anti-VEGF or 12–16 weeks post-steroid injection, stratified by initial DME stage. Results Of the 560 eyes studied (62% male, mean age 66.7 years), 31% were classified as stage 1 (early), 50% stage 2 (advanced), 17% stage 3 (severe), and 2% stage 4 (atrophic). Visual acuity (VA; decimal) improved by 0.12–0.15 decimals in stages 1–2 but only 0.03 decimal in stage 3 (all p  
ISSN:2193-8245
2193-6528
DOI:10.1007/s40123-024-00925-y