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The UK Diabetic Retinopathy Electronic Medical Record (UK DR EMR) Users Group, Report 2: real-world data for the impact of cataract surgery on diabetic macular oedema.

Denniston, Alastair K and Chakravarthy, Usha and Zhu, Haogang and Lee, Aaron Y and Crabb, David P and Tufail, Adnan and Bailey, Clare and Akerele, Toks and Al-Husainy, Sahar and Brand, Christopher and Downey, Louise and Fitt, Alan and Khan, Rehna and Kumar, Vineeth and Lobo, Aires and Mahmood, Sajjad and Mandal, Kaveri and Mckibbin, Martin and Menon, Geeta and Natha, Salim and Ong, Jong Min and Tsaloumas, Marie D and Varma, Atul and Wilkinson, Elizabeth and Johnston, Robert L and Egan, Catherine A (2017) The UK Diabetic Retinopathy Electronic Medical Record (UK DR EMR) Users Group, Report 2: real-world data for the impact of cataract surgery on diabetic macular oedema. The British journal of ophthalmology. ISSN 1468-2079.

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Official URL: http://bjo.bmj.com/

Abstract

AIM

To assess the rate of 'treatment-requiring diabetic macular oedema (DMO)' in eyes for the two  years before and after cataract surgery.

METHODS

Multicentre national diabetic retinopathy (DR) database study with anonymised data extraction across 19 centres from an electronic medical record system.

INCLUSION CRITERIA

eyes undergoing cataract surgery in patients with diabetes with no history of DMO prior to study start. The minimum dataset included: age, visual acuity (all time-points), injection episodes, timing of cataract surgery and ETDRS grading of retinopathy and maculopathy.

MAIN OUTCOME MEASURE

rate of developing first episode of treatment-requiring DMO in relation to timing of cataract surgery in the same eye.

RESULTS

4850 eyes met the inclusion criteria. The rate of developing treatment-requiring DMO in this cohort was 2.9% in the year prior to surgery versus 5.3% in the year after surgery (p<0.01). The risk of 'treatment-requiring DMO' increased sharply after surgery, peaking in the 3-6 months' period (annualised rates of 5.2%, 6.8%, 5.6% and 4.0% for the 0-3, 3-6, 6-9 and 9-12 months' post-operative time periods respectively). Risk was associated with pre-operative grade of retinopathy: risk of DMO in the first year post-operatively being 1.0% (no DR pre-operatively), 5.4% (mild non-proliferative diabetic retinopathy; NPDR), 10.0% (moderate NPDR), 13.1% (severe NPDR) and 4.9% (PDR) (p<0.01).

CONCLUSIONS

This large real-world study demonstrates that the rate of developing treatment-requiring DMO increases sharply in the year after cataract surgery for all grades of retinopathy, peaking in the 3-6 months' postoperative period. Patients with moderate and severe NPDR are at particularly high risk.

Item Type: Article
Subjects: WW Eyes. Ophthalmology
Divisions: Ambulatory Care > Ophthalmology
Related URLs:
Depositing User: Mrs Yolande Brookes
Date Deposited: 25 May 2017 10:10
Last Modified: 25 May 2017 10:10
URI: http://www.repository.heartofengland.nhs.uk/id/eprint/1375

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