0
Original Investigation | Clinical Sciences, Journal Club

Macular Edema After Cataract Surgery in Eyes Without Preoperative Central-Involved Diabetic Macular Edema

Diabetic Retinopathy Clinical Research Network Authors/Writing Committee; Carl W. Baker, MD1; Talat Almukhtar, MBChB2; Neil M. Bressler, MD3; Adam R. Glassman, MS2; Sandeep Grover, MD4; Stephen J. Kim, MD5; Timothy J. Murtha, MD6; Michael E. Rauser, MD7; Cynthia Stockdale, MSPH2
[+] Author Affiliations
1Paducah Retinal Center, Paducah, Kentucky
2Jaeb Center for Health Research, Tampa, Florida
3Wilmer Ophthalmological Institute, Baltimore, Maryland
4Department of Ophthalmology, Jacksonville Health Science Center, University of Florida College of Medicine, Jacksonville
5Vanderbilt University Medical Center, Nashville, Tennessee
6Joslin Diabetes Center, Boston, Massachusetts
7Department of Ophthalmology, Loma Linda University Health Care, Loma Linda, California
JAMA Ophthalmol. 2013;131(7):870-879. doi:10.1001/jamaophthalmol.2013.2313.
Text Size: A A A
Published online

Importance  The incidence of development or worsening of macular edema (ME) is variable in eyes without diabetic ME (DME) undergoing cataract surgery.

Objective  To estimate the incidence of central-involved ME 16 weeks following cataract surgery in eyes with diabetic retinopathy without definite central-involved DME preoperatively.

Design, Setting, and Participants  In a multicenter, prospective, observational study, 293 participants with diabetic retinopathy without definite central subfield thickening on optical coherence tomography (OCT) underwent cataract surgery.

Exposure  Cataract extraction surgery performed within 28 days of enrollment of eyes without DME in individuals with diabetes mellitus.

Main Outcomes and Measures  Development of central-involved ME defined as the following: (1) OCT central subfield thickness of 250 μm or greater (time-domain OCT) or 310 μm or greater (spectral-domain OCT) with at least a 1-step increase in logOCT central subfield thickness preoperatively to the 16-week visit; (2) at least a 2-step increase in logOCT central subfield thickness preoperatively to the 16-week visit; or (3) nontopical treatment for ME received before the 16-week visit with either of the OCT criteria met at the time of treatment.

Results  The median participant age was 65 years. The median visual acuity letter score was 69 letters (Snellen equivalent 20/40). Forty-four percent of eyes had a history of treatment for DME. Sixteen weeks postoperatively, central-involved ME was noted in 0% (95% CI, 0%-20%) of 17 eyes with no preoperative DME. Of eyes with non–central-involved DME, 10% (95% CI, 5%-18%) of 97 eyes without central-involved DME and 12% (95% CI, 7%-19%) of 147 eyes with possible central-involved DME at baseline progressed to central-involved ME. History of DME treatment was significantly associated with central-involved ME development (P < .001).

Conclusions and Relevance  In eyes with diabetic retinopathy without concurrent central-involved DME, presence of non–central-involved DME immediately prior to cataract surgery or history of DME treatment may increase the risk of developing central-involved ME 16 weeks after cataract extraction.

Sign In to Access Full Content

Don't have Access?

Register and get free email Table of Contents alerts, saved searches, PowerPoint downloads, CME quizzes, and more

Subscribe for full-text access to content from 1998 forward and a host of useful features

Activate your current subscription (AMA members and current subscribers)

Purchase Online Access to this article for 24 hours

Figures

Tables

References

Correspondence

CME
Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).
Submit a Comment

Multimedia

Some tools below are only available to our subscribers or users with an online account.

Sign In to Access Full Content

Related Content

Customize your page view by dragging & repositioning the boxes below.

See Also...
Articles Related By Topic
Related Topics
PubMed Articles
Jobs
brightcove.createExperiences();