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Posterior Segment Diabetic Macular Edema/Patient Survey Comparison of Diabetic Macular Edema Treatment Patterns and Outcomes by European and US Retina-treating Ophthalmologists Eric G John, MS 1 and James F Harris, BBA 2 1. Senior Vice President, SciMedica Group, Conshohocken, Pennsylvania, US; 2. Executive Director, Marketing, Alimera Sciences, Alpharetta, Georgia, US Abstract AIM: To uncover and evaluate diabetic macular edema (DME) patient treatment patterns in the US and the largest EU countries. METHODS: Quantitative analyses of self-report data from retina-treating ophthalmologists via 30-minute Internet-based surveys. Data were collected across the US (one study) and EU (two studies­—EU-1 and EU-2) between November 2011 and January 2013. Visual outcomes and rates of treatment success or failure were evaluated. RESULTS: Respondents were surveyed across the US (n=71) and EU (EU-1: n=180; EU-2: n=106). Nearly one-third of treated patients (US 38.6 %; EU-1 37.8 %; EU-2 30.7 %) reached a plateau in vision improvement. Geographical comparison showed no significant difference in responses between the US and the EU (EU-1, EU-2) (p>0.05). CONCLUSIONS: These data help to quantify the size of the chronic DME patient population in the US and EU, which is not achieving an acceptable functional outcome with current therapy. The paper provides solid empirical evidence regarding similarities in DME patient treatment and outcomes in the US and EU. The global and reproducible similarities in terms of physicians’ perceptions of the threshold of DME treatment burden and the visual outcomes when treatment benefit is limited are compelling. This is especially interesting within the present context where information regarding the effect of current treatments is limited. Diabetes is growing around the world at epidemic proportions, and these data provide insight into the impact DME may have on healthcare systems. Keywords Diabetic macular edema, DME, treatment, epidemiology, United States, Europe Disclosure: Eric G John, MS, is an employee of SciMedica Group Marketing Research and Consulting. James F Harris, BBA, is an employee of Alimera Sciences. Alimera Sciences provided funding for this research. The sponsor participated in the study design and manuscript review and approval, but was not involved in the review, synthesis, and interpretation of the results. Received: December 4, 2013 Accepted: January 30, 2014 Citation: US Ophthalmic Review, 2014;7(1):63–7 Correspondence: Eric G John, MS, 20 E 2nd Ave, Conshohocken, PA 19428, US. E: ejohn@scimedicagroup.com Support: The publication of this article was supported by Alimera Sciences. The views and opinions expressed are those of the author and not necessarily those of Alimera Sciences. The global medical, financial, and personal toll of type 1 and 2 diabetes is well documented. In the US, the total cost of diabetes to the US healthcare system was estimated at US$174 billion (€126 billion) in 2007. 1 The International Diabetes Federation estimates that diabetes health costs were US$105.5 billion (€82.2 billion) in the European region in 2010. 2 As the prevalence of diabetes is expected to rise more than 50 % globally between 2000 and 2030, these costs are expected to continue to grow. 3 While robust data regarding the impact of type 1 and 2 diabetes are readily available, information on at least one condition secondary to diabetes, specifically diabetic macular edema (DME), is lacking in publically available literature. A particular gap exists regarding the relationship between the scope of the disease and the corresponding effectiveness of long-term treatment. The authors concluded that little was known about the epidemiology of DME in Europe. The lack of recent data in the US and limited European epidemiological studies based on relatively small patient populations has led to a call for more research in this arena. 4 Highlighting this lack of information, a 2010 literature review on the burden of illness of DME in the US and Europe uncovered 47 articles pertinent to the discussion of the impact of the disease between 1980 and 2009. 4 Some recent and relevant analysis of the prevalence of DME among those with diabetes does, however, exist. A 2012 meta-analysis of 35 studies from 1980 to 2008 estimated the prevalence for DME to be 6.81 % © TO U C H M ED IC A L MED IA 2014 Even when information regarding the burden of DME treatment is robust, it is often no longer timely. In the US, the benchmark epidemiological study of DME is the Wisconsin Epidemiological Study of Diabetic Retinopathy (WESDR). 5 The WESDR, a prospective, population-based, cohort study that enrolled diabetes patients both under and over the age of 30 from 1980 to 1982 is now over 30 years old and does not reflect currently available treatment. 63