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Purpose  To examine the prevalence of central retinal atrophy in patients treated for diabetic macular edema (DME) in a clinical setting.    Methods  Retrospective data analysis of patients with  DME , focusing on those who developed central retinal thinning after  DME  treatment at the Department of Ophthalmology, Medical University Vienna. Patient characteristics and clinical data including best‐corrected visual acuity (BCVA), spectral domain optical coherence tomography and fluorescence angiography images were reviewed and  DME  treatment strategies analysed using descriptive statistics. The correlation between visual acuity and ocular, systemic or  DME  treatment factors was calculated using linear regression models and  ancova s.    Results  A total of 6684 outpatient visits by 1437 patients with diabetes were analysed. Out of 149 patients, who had had a central subfield thickness (CST) below 200  μ m, 32 (36 eyes) had previously been diagnosed with a centre involving  DME  with an average  CST  of 473 ± 103  μ m and average visual acuity of 0.62 ± 0.44 log MAR  at first presentation. At the time of central atrophy, 29 (81%) out of 36 eyes had a history of laser treatment, 11 (31%) a vitrectomy, 32 (88%) repeated intravitreal injections of anti‐vascular endothelial growth factor ( VEGF ; mean 5.3 ± 3.8) and 22 (61%) intravitreal corticosteroid injections (mean 2.5 ± 2.7). Visual function (0.67 ± 0.43 log MAR ) at the time of atrophy was not significantly correlated to central retinal thickness (191 ± 7  μ m) or any other ocular, systemic or treatment factors.    Conclusions  Only 4% of patients treated for  DME  developed central retinal thinning in our observation period. On average, our atrophy patients had higher  CST  and lower BCVA when they first presented with  DME  compared to the overall  DME  cohort, and they received a combination of intravitreal injections and laser for  DME  treatment. Central retinal atrophy might not be attributed to excessive use of intravitreally applied anti‐ VEGF  or any other  DME  therapy alone.

Atrophy of the central neuroretina in patients treated for diabetic macular edema