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Background/objectives <p>The initial visual acuity (VA) prior to treatment initiation can significantly influence long-term visual outcomes. The current analysis aimed to examine change in VA by baseline vision categories and their effects on time spent within visual change categories in patients with diabetic macular oedema (DMO) who underwent treatment with the intravitreal fluocinolone acetonide (FAc) implant.</p> Subjects/methods <p>This was a post-hoc analysis of the IRISS-Registry Data. Time-in-range (TIR) was calculated based on three VA letter-score-thresholds: ≥70, ≥65, and ≥60 ETDRS letters after treatment initiation. TIR was stratified by baseline VA in three groups: 0–33, 34–68, and 69–100 letters. The primary outcome was the mean TIR for the ≥70 letters threshold (equivalent to 6/12 in Snellen).</p> Results <p>A total of 671 eyes from 542 patients were included. VA improved significantly in all VA swimlane groups, with 84.8%, 71.7%, and 60.0% of eyes in the 0–33, 34–68, and 69–100 baseline VA categories, respectively, showing maintained or improved VA at 36 months (<i>p</i> = 0.0367). The mean TIR for the ≥70 letter threshold was significantly longer in the 69–100 letters subgroup (892.7 ± 413.4 days) compared to the 34–68 (648.4 ± 366.4 days) and 0–33 (251.3 ± 175.9 days) subgroups (<i>p</i> &lt; 0.0001). No significant differences in TIR were observed based on the duration of DMO or the number of previous anti-angiogenic injections.</p> Conclusions <p>Eyes with better initial VA maintained functionally better visual acuity for longer following FAc implant treatment. TIR emerged as a potentially clinically relevant endpoint for evaluating long-term treatment outcomes in DMO, offering a broader perspective than traditional VA measures.</p>

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Impact of baseline visual acuity, time-in-range and early treatment on functional outcomes in DMO: insights from the IRISS outcomes

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年12月3日

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  • Igor Kozak,
  • Ramin Khoramnia,
  • Simon R. Taylor,
  • Usha Chakravarthy,
  • Robin Hamilton,
  • Usha Chakravarthy,
  • Guzaliya Safiullina,
  • Geeta Menon,
  • Ramesh Sivaraj,
  • Haralabos Eleftheriadis,
  • Simon R. Taylor,
  • Saad Younis,
  • Konstantinos Balaskas,
  • Vasant Raman,
  • Fahd Quhill,
  • Bushra Mushtaq,
  • Nicholas Glover,
  • Ben Burton,
  • David Steel,
  • Salim Natha,
  • Somnath Banerjee,
  • Deepthi Seneviratne,
  • Nishal Patel,
  • Spyridon Mourtzoukos,
  • Riaz Asaria,
  • Ajay Bhatnagar,
  • Rehna Khan,
  • Ahmed Kamal,
  • Clare Bailey,
  • Louise Downey,
  • Anil Kumar,
  • Gonçalo Almeida,
  • Patrick Richardson,
  • Hadi Zambarakji,
  • Colin Jones,
  • Katrin Lorenz,
  • Karl U. Bartz-Schmidt,
  • Frank Holz,
  • Lars Wagenfeld,
  • Peter Wiedemann,
  • Rainer Guthoff,
  • Manfred Tetz,
  • Gerd U. Auffarth,
  • Christian Ksinsik,
  • Frank Koch,
  • Helmut Sachs,
  • Dirk Sandner,
  • Berthold Seitz,
  • João Figueira,
  • Ângela Carneiro,
  • José Henriques,
  • Rufino Silva,
  • Miguel Amaro,
  • Angelina Meireles,
  • João Paulo Castro Sousa,
  • António Rodrigues,
  • Rui Carvalho

摘要

Background/objectives

The initial visual acuity (VA) prior to treatment initiation can significantly influence long-term visual outcomes. The current analysis aimed to examine change in VA by baseline vision categories and their effects on time spent within visual change categories in patients with diabetic macular oedema (DMO) who underwent treatment with the intravitreal fluocinolone acetonide (FAc) implant.

Subjects/methods

This was a post-hoc analysis of the IRISS-Registry Data. Time-in-range (TIR) was calculated based on three VA letter-score-thresholds: ≥70, ≥65, and ≥60 ETDRS letters after treatment initiation. TIR was stratified by baseline VA in three groups: 0–33, 34–68, and 69–100 letters. The primary outcome was the mean TIR for the ≥70 letters threshold (equivalent to 6/12 in Snellen).

Results

A total of 671 eyes from 542 patients were included. VA improved significantly in all VA swimlane groups, with 84.8%, 71.7%, and 60.0% of eyes in the 0–33, 34–68, and 69–100 baseline VA categories, respectively, showing maintained or improved VA at 36 months (p = 0.0367). The mean TIR for the ≥70 letter threshold was significantly longer in the 69–100 letters subgroup (892.7 ± 413.4 days) compared to the 34–68 (648.4 ± 366.4 days) and 0–33 (251.3 ± 175.9 days) subgroups (p < 0.0001). No significant differences in TIR were observed based on the duration of DMO or the number of previous anti-angiogenic injections.

Conclusions

Eyes with better initial VA maintained functionally better visual acuity for longer following FAc implant treatment. TIR emerged as a potentially clinically relevant endpoint for evaluating long-term treatment outcomes in DMO, offering a broader perspective than traditional VA measures.