Indicators of Visual Prognosis in Diabetic Macular Oedema

Diabetic macular oedema (DMO) is an important cause of moderate vision loss in people with diabetes. Advances in imaging technology have shown that a significant proportion of patients with DMO respond sub-optimally to existing treatment options. Identifying associations and predictors of response before treatment is initiated may help in explaining visual prognosis to patients and aid the development of personalized treatment strategies. Imaging features, such as central subfoveal thickness, photoreceptor integrity, disorganization of retinal inner layers, choroidal changes, and macular perfusion, have been reported to be prognostic factors of visual acuity (VA) in DMO. In this review we evaluated each risk factor to understand their relative importance in visual prognostication of DMO eyes post-treatment. Although individually, some of these factors may not be significant predictors, in combination they may form phenotypes that can inform visual prognosis. Stratification based on these phenotypes needs to be developed to progress to personalized medicine for DMO.

Automated summary

The review evaluated the relative importance of each risk factor in visual prognostication of diabetic macular oedema (DMO) eyes post-treatment and emphasized the significance of phenotypes formed by combining these factors in predicting visual outcomes. The development of stratification based on these phenotypes for personalized medicine in DMO treatment was proposed.