ArticleOphthalmology and therapy2024
Enhancing Diabetic Macular Edema Treatment Outcomes: Exploring the ESASO Classification and Structural OCT Biomarkers.
Article in Ophthalmology and therapy, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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10 citing papers in PubMed, 13 citations in OpenAlex.
- Association between peripheral blood biomarkers and diabetic macular edema.Acta diabetologica · 2026Article
- Optical Coherence Tomography Biomarkers as Potential Predictors for Visual Function and Response to Intravitreal Therapy in Diabetic Macular Edema.Journal of vitreoretinal diseases · 2026Article
- Early dynamic response on spectral-domain OCT predicts long-term visual outcome in diabetic macular edema treated with aflibercept.BMC ophthalmology · 2026Article
- Scan Density Matters: Reproducibility of AI-Derived OCT Biomarkers in Diabetic Macular Edema.Translational vision science & technology · 2026Article
- Biomarkers of Diabetic Macular Edema on Optical Coherence Tomography After Cataract Surgery.Journal of vitreoretinal diseases · 2026Article
- Development and standardisation of 'time-in-range' measurement for clinical endpoints in retinal diseases.Eye (London, England) · 2026Review
- First-year real-world outcomes of faricimab in clinically significant diabetic macular oedema: a Swiss retina research network report.BMJ open ophthalmology · 2026Article
- Artificial Intelligence Driven Adjusted OCT-Based Classification System for Diabetic Macular Edema (AIDME).Clinical ophthalmology (Auckland, N.Z.) · 2026Article
- What Lies beneath Diabetic Macular Edema: Latent Phenotypic Clustering and Differential Treatment Responses to Intravitreal Therapies.Ophthalmology science · 2026Article
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9 authors at 4 institutions in 2 countries.
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Abstract
introductionThis 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.
methodsIn 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.
resultsOf 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 < 0.0001) and 0.01 in stage 4 (p = 0.38). Even in eyes with low baseline VA ≤ 0.3, improvements were significant only in stages 1 and 2 (0.12 and 0.17 decimals, respectively). Central subfield thickness (CST) improvement was greatest in stage 3 (-229 µm, 37.6%, p < 0.0001), but uncorrelated with VA gains, unlike stages 1 and 2 (respectively: -142 µm, 27.4%; - 5 µm, 12%; both p < 0.0001). Stage 4 showed no significant CST change. Baseline disorganization of retinal inner layers and focal damage of the ellipsoid zone/external limiting membrane did not influence VA improvement in stages 1 and 2. Treatment patterns varied, with 61% receiving anti-VEGF and 39% dexamethasone, influenced by DME stage, with no significant differences between therapeutic agents.
conclusionThe ESASO classification, which views the retina as a neurovascular unit and integrates multiple biomarkers, surpasses single biomarkers in predicting visual outcomes. Significant functional improvement occurred only in stages 1 and 2, suggesting reversible damage, whereas stages 3 and 4 likely reflect irreversible damage.
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