Incidence of Visual Loss in Patients With Diabetic Macular Ischemia

Purpose: To report on the 1-year incidence and risk factors of visual loss in patients with diabetic macular ischemia. Methods: Prospective, observational cohort. Patients had stable panretinal photocoagulation treated eyes for either proliferative diabetic retinopathy or severe nonproliferative diabetic retinopathy. Main outcomes measures: best-corrected visual acuity and low luminance visual acuity. Optical coherence tomography, optical coherence tomography angiography, and retinal sensitivity were recorded at baseline and week 52. Results: The cohort included 53 patients and 66 eyes. The mean (SD) age was 57.9 (10.6) years, with a mean (SD) diabetes duration of 17.9 (11.0) years. 40.4% of eyes lost ≥5 best-corrected visual acuity and/or low luminance visual acuity letters. Disorganization of retinal layers was observed in 71.4% of eyes with vision loss compared with 38.7% of eyes without vision loss, odds ratio = 3.96 (95% confidence interval, 1.25–13.84, P = 0.02). Baseline deep vascular density and superficial vascular density correlated positively with week 52 best-corrected visual acuity (rho = 0.32, 95% CI: −0.02 to 0.59; P = 0.05) and week 52 low luminance visual acuity (rho = 0.33, 95% confidence interval −0.02 to –0.61; P = 0.04), respectively. Conclusion: Disorganization of the retinal inner layers was associated with vision loss, and baseline optical coherence tomography angiography vascular parameters positively predicted visual acuity outcomes.