Incidence of Visual Loss in Patients with Diabetic Macular Ischemia (DMI) A 1- year Prospective Study

To report on the 1-year incidence and risk factors of visual loss in patients with diabetic macular ischemia.

Prospective, observational cohort. Patients had stable panretinal photocoagulation treated eyes for either proliferative diabetic retinopathy or severe non-proliferative diabetic retinopathy. Main outcomes measures: best corrected visual acuity (BCVA) and low luminance visual acuity (LLVA). Optical coherence tomography (OCT), OCT angiography (OCTA), and retinal sensitivity were recorded at baseline and week 52.

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 BCVA and/or LLVA letters. Disorganization of retinal layers (DRIL) was observed in 71.4% of eyes with vision loss compared to 38.7% of eyes without vision loss, odds ratio=3.96 (95% CI, 1.25 to 13.84, P=0.02). Baseline deep vascular density and superficial vascular density correlated positively with week 52 BCVA (rho=0.32, 95% CI: -0.02 to 0.59; P=0.05) and week 52 LLVA (rho=0.33, 95% CI -0.02 to 0.61; P=0.04) respectively.

DRIL was associated with vision loss, and baseline OCTA vascular parameters positively predicted VA outcomes.