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Eye (Lond). 2012 Jun;26(6):833-40. doi: 10.1038/eye.2012.53. Epub 2012 Mar 23.

Observational study of subclinical diabetic macular edema.

Collaborators (217)

Elman MJ, Sloan MD, Starr J, Butcher TM, Singletary PV, Gore N, Coffey T, Andreani G, Sotirakos P, Cain T, Sharuk GS, Arrigg PG, Schlossman DK, Murtha TJ, Sun JK, Shah ST, Stockman ME, Kopple A, Cavicchi RW, Stone TW, Kitchens JW, Wood WJ, Buck M, Van Arsdall J, Cruz JL, Slade EA, Blevins ST, Browning D, Antoszyk AN, Brooks DR, Helms JV, Price AK, Cowen MK, Karow AS, Murphy HL, McOwen MD, Davis LM, Clark LM, Balasubramaniam UM, McClain D, Powers ME, Braverman JM, Ciardella AP, Ryman LS, Montalvo SI, Zapata JD, Rhodes RC, Brown DM, Lyon AT, Gill MK, Kaminski LA, Ackatz LE, O'Donnell LM, Shankle J, Ryan DM, Friedman SM, Blackmer KA, Key JS, Sjoblom K, Fagan DA, Carlton S, McKinney A, Krzystolik MG, Savell MB, Henriques S, Bache JE, Gross JG, Flowers AM, Lovit HK, Price RL, Kinyoun JL, Rath SA, Clifton BC, Leslie JD, Beer PM, Garza D, Olmeda E, Whitney C, Fischer J, Solomon SD, Bressler S, Frey M, West S, Donohue D, Graul J, Emmert D, Edwards PA, Rock SM, Murphy J, Rusinek BA, Troszak TA, Davis GH, Li HK, Spillar H, Bourg JM, Crocker A, Kelso CN, Cummings HL, Long DJ, Carpenter S, Berry JP, Googe JM, Higdon CT, Hunt C, Blais PA, Kim JE, Han DP, Wirostko WJ, Alvarez D, Graf J, Flanders J, Beringer JR, Backes DB, Chan CK, Walther KS, Castillo SU, Huff KM, Chesbrough DJ, Smith CW, Janigian RH, Woodcome HA, DuCoty CL, Varadian S, Banalewicz E, Hamel M, Nagle AL, Glassman AR, Beck RW, Almukhtar T, Arnold BJ, Dale BB, Baptista A, Constantine SR, Dupre SS, Edwards AR, Huggins ML, Johnson PA, Lester LA, Loggins BL, Malka EB, McClellan SL, Melia M, Miller KM, Moke PS, Qin H, Pritchard R, Scott E, Stockdale CR, Davis MD, Gangaputra S, Danis RP, Hubbard L, Reimers J, Vargo P, Moeller E, Myers D, Burmeister K, Gamma V, Bressler NM, Lawson C, Orr PR, Wellman B, Bressler SB, Friedman S, Baker CW, Scott IU, Schron E, Everett DF, Miskala PH, Maturi RK, Bressler NM, Aiello LP, Baker CW, Beck RW, Bressler SB, Brucker AJ, Chalam KV, Danis RP, Davis MD, Elman MJ, Ferris FL 3rd, Friedman S, Glassman AR, Googe J Jr, Schron E, Starr J, Sun JK, Antoszyk AN, Bhavsar A, Brown DM, Browning DJ, Everett DF, Fish J, Lauer A, McLeod K, Miskala PH, Grinnell CJ, Scott IU, Bressler NM, Browning D, Brucker AJ, Carlton S, Chew EY, Danis RP, Haller JA, Aiello LP, Baker CW, Bunch DP, Everett DF, Ferris FL 3rd, Fong DS, Glassman AR, Gross JG, Li HK, Marcus DM, Miskala P, Price AK.

Author information

Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA.

Erratum in

  • Eye (Lond). 2012 Jun;26(6)900-1.



To determine the rate of progression of eyes with subclinical diabetic macular edema (DME) to clinically apparent DME or DME necessitating treatment during a 2-year period.


In all, 43 eyes from 39 study participants with subclinical DME, defined as absence of foveal center edema as determined with slit lamp biomicroscopy but a center point thickness (CPT) between 225 and 299 μm on time domain (Stratus, Carl Zeiss Meditec) optical coherence tomography (OCT) scan, were enrolled from 891 eyes of 582 subjects screened. Eyes were evaluated annually for up to 2 years for the primary outcome, which was an increase in OCT CPT of at least 50 μm from baseline and a CPT of at least 300 μm, or treatment for DME (performed at the discretion of the investigator).


The cumulative probability of meeting an increase in OCT CPT of at least 50 μm from baseline and a CPT of at least 300 μm, or treatment for DME was 27% (95% confidence interval (CI): 14%, 38%) by 1 year and 38% (95% CI: 23%, 50%) by 2 years.


Although subclinical DME may be uncommon, this study suggests that between approximately one-quarter and one-half of eyes with subclinical DME will progress to more definite thickening or be judged to need treatment for DME within 2 years after its identification.

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