Severity of type 2 diabetes in Seine St Denis among patients with diabetic macular edema treated by antiVEGF

Abstract

AbstractPurpose Diabetic macular edema (DME) is the main cause of loss of vision over the course of diabetes. In this study we sought to know whether DME was more severe in Seine st Denis, a french area, where the poverty is higher than in other french placMethods We enrolled all patients suffering from DME and treated by ranibizumab intravitreal injections between November 2012 and April 2013. In order to evaluate the severity of DME and the medical management of diabetes of these patients, we collected the following parameters: central macular thickness measured by SD‐OCT, the best corrected visual acuity, diabetic retinopathy severity, HbA1c, diabetes duration, and associated diseases.Results We included 25 type 2 diabetic patients (8 women and 17 men), the mean age was 64± 8,1 years. Mean central macular thickness was 523 ± 145 μm. The best corrected visual acuity was 51 letters at baseline (counting fingers‐ 70 letters). 22 patients (88%) had a severe non proliferative diabetic retinopathy or a proliferative diabetic retinopathy. Mean HbA1c was 7,8% (+/‐ 2,3%). For 23 cases (92%), diabetes was associated with high blood pressure, and the average was 14,5±2 /8,5 ± 1,3 mmHg. Diabetes lasted for 13,1 years at baseline.Conclusion Diabetic patients, in this case series, had a more severe DME regarding macular thickness and visual acuity than patients from large randomized studies found in the literature. This severity could be due to a sub optimal management of their diabetes. DME may become a tool to witness a limited access to good medical cares.