After examining the prevalence of central retinal atrophy in patients treated for diabetic macular edema (DME), Austrian researchers found that only 4% of these patients developed central retinal thinning.

The retrospective study analyzed 6,684 outpatient visits by 1,437 patients with diabetes. The team reviewed patient characteristics and clinical data, including best‐corrected visual acuity (BCVA) and OCT and fluorescence angiography images. They also evaluated DME treatment strategies to assess the correlation between visual acuity and ocular, systemic or DME treatment factors.

Of the 149 patients with central subfield thickness (CST) below 200μm, the study authors discovered that 32 patients (36 eyes) had been diagnosed with DME with an average CST of 473±103μm and visual acuity of 0.62±0.44logMAR at first presentation. At the time of central atrophy, they note that 81% of the 36 eyes had previous laser treatment, 31% had a vitrectomy, 88% had repeat intravitreal injections of anti‐VEGF and 61% had intravitreal corticosteroid injections. Visual function (0.67±0.43logMAR) at the time of atrophy did not significantly correlate to central retinal thickness (191±7μm) or any other ocular, systemic or DME treatment factors.

The researchers concluded that central retinal atrophy might not be attributed to excessive use of intravitreal anti‐VEGF or any other DME therapy alone.

Karst SG, Schuster M, Mitsch C, et al. Atrophy of the central neuroretinal in patients treated for diabetic macular edema. Acta Ophthalmologica. June 22, 2019. [Epub ahead of print].