{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,6]],"date-time":"2026-05-06T18:11:03Z","timestamp":1778091063595,"version":"3.51.4"},"reference-count":35,"publisher":"BMJ","funder":[{"DOI":"10.13039\/501100000925","name":"NHMRC","doi-asserted-by":"crossref","award":["2021-5 : #1195021"],"award-info":[{"award-number":["2021-5 : #1195021"]}],"id":[{"id":"10.13039\/501100000925","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100004337","name":"Roche","doi-asserted-by":"publisher","award":["N\/A"],"award-info":[{"award-number":["N\/A"]}],"id":[{"id":"10.13039\/100004337","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100004326","name":"Bayer","doi-asserted-by":"publisher","award":["N\/A"],"award-info":[{"award-number":["N\/A"]}],"id":[{"id":"10.13039\/100004326","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Br J Ophthalmol"],"accepted":{"date-parts":[[2026,4,24]]},"abstract":"<jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>To compare 1-year and 2-year outcomes of eyes with persistent and non-persistent diabetic macular oedema (DME) treated with vascular endothelial growth factor (VEGF) inhibitors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This was a cohort study using the Fight Retinal Blindness! (FRB!) international outcomes registry. Participants had treatment-na\u00efve eyes with centre-involving DME starting intravitreal VEGF inhibitor therapy from 2014 to 2023. Eyes were grouped as those with persistent DME and those with non-persistent DME. Main outcome measures were mean visual acuity (VA) change and central subfoveal thickness change after 1 and 2 years of treatment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>This study included 877 eyes, of which 40% had persistent DME. The mean VA change in eyes with persistent DME was less than that in eyes with non-persistent DME at 1 (+3.6 vs. +6.5 letters; p&lt;0.001) and 2 (+3.6 vs. +6.3 letters; p&lt;0.001) years. The persistent group had a lower mean reduction in central subfield thickness at 1 (\u221274\u2009vs \u2212111\u2009\u00b5m; p&lt;0.001) and 2 (\u221290\u2009vs \u2212114\u2009\u00b5m; p&lt;0.001) years and received more mean injections at 1 (7.6 vs 6.5; p&lt;0.001) and 2 (11.8 vs 9.5; p&lt;0.001) years.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Eyes with persistent DME had significantly lower improvement in mean VA, lower reduction in CST and more injections 1 and 2 years after the initiation of VEGF inhibitor therapy. Eyes with persistent DME likely had a higher treatment burden because they had more aggressive disease that was more difficult to control. More effective agents would likely deliver better outcomes in this significant group of patients with DME.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bjo-2025-328621","type":"journal-article","created":{"date-parts":[[2026,5,6]],"date-time":"2026-05-06T17:20:12Z","timestamp":1778088012000},"page":"bjo-2025-328621","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Outcomes of eyes with persistent diabetic macular oedema: The Fight Retinal Blindness! Project"],"prefix":"10.1136","author":[{"given":"Samantha","family":"Fraser-Bell","sequence":"first","affiliation":[{"name":"Department of Ophthalmology, Sydney Hospital and Sydney Eye Hospital, Sydney, New South Wales, Australia"},{"name":"The Faculty of Medicine and Health, The University of Sydney Save Sight Institute, Sydney, New South Wales, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9507-6379","authenticated-orcid":false,"given":"Natalie Si-Yi","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Sydney Hospital and Sydney Eye Hospital, Sydney, New South Wales, Australia"},{"name":"The Faculty of Medicine and Health, The University of Sydney Save Sight Institute, Sydney, New South Wales, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7944-6923","authenticated-orcid":false,"given":"Yohei","family":"Hashimoto","sequence":"additional","affiliation":[{"name":"Save Sight Institute, The University of Sydney Faculty of Medicine and Health, Sydney, New South Wales, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3902-239X","authenticated-orcid":false,"given":"Andreas","family":"Pollreisz","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Medical University of Vienna, Vienna, Vienna, Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antonella","family":"Witmer","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, OLVG Hospital, Amsterdam, Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1208-913X","authenticated-orcid":false,"given":"Francesco","family":"Viola","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Fondazione IRCCS Ca\u2019 Granda Ospedale Maggiore Policlinico, Milan, Italy"},{"name":"Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francisco Javier","family":"Lavid","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Hospital Punta Europa Algeciras, Algeciras, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Helen","family":"Steiner","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, The Royal Victorian Eye and Ear Hospital, East Melbourne, Victoria, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pierre-Henry","family":"Gabrielle","sequence":"additional","affiliation":[{"name":"The Faculty of Medicine and Health, The University of Sydney Save Sight Institute, Sydney, New South Wales, Australia"},{"name":"Service d\u2019Ophtalmologie, CHU Dijon, Dijon, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Richard","family":"Barry","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Canberra Health Services, Garran, Australian Capital Territory, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8676-0833","authenticated-orcid":false,"given":"Rufino","family":"Silva","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, University of Coimbra, Coimbra, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel","family":"Barthelmes","sequence":"additional","affiliation":[{"name":"The Faculty of Medicine and Health, The University of Sydney Save Sight Institute, Sydney, New South Wales, Australia"},{"name":"Department of Ophthalmology, Medical University of Vienna, Vienna, Vienna, Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8580-0274","authenticated-orcid":false,"given":"Mark C","family":"Gillies","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Sydney Hospital and Sydney Eye Hospital, Sydney, New South Wales, Australia"},{"name":"The Faculty of Medicine and Health, The University of Sydney Save Sight Institute, Sydney, New South Wales, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2026,5,6]]},"reference":[{"key":"2026050610200661000_bjo-2025-328621v1.1","doi-asserted-by":"crossref","first-page":"90","DOI":"10.1016\/j.ajo.2021.06.030","article-title":"Fluctuations in Central Subfield Thickness Associated With Worse Visual Outcomes in Patients With Diabetic Macular Edema in Clinical Trial Setting","volume":"232","author":"Starr","year":"2021","journal-title":"Am J Ophthalmol"},{"key":"2026050610200661000_bjo-2025-328621v1.2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ophtha.2011.12.039"},{"key":"2026050610200661000_bjo-2025-328621v1.3","doi-asserted-by":"publisher","DOI":"10.1016\/j.ophtha.2014.05.006"},{"key":"2026050610200661000_bjo-2025-328621v1.4","doi-asserted-by":"publisher","DOI":"10.1016\/j.ophtha.2009.01.011"},{"key":"2026050610200661000_bjo-2025-328621v1.5","doi-asserted-by":"publisher","DOI":"10.1016\/j.ophtha.2015.03.024"},{"key":"2026050610200661000_bjo-2025-328621v1.6","doi-asserted-by":"publisher","DOI":"10.1016\/j.ophtha.2010.02.031"},{"key":"2026050610200661000_bjo-2025-328621v1.7","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1414264"},{"key":"2026050610200661000_bjo-2025-328621v1.8","doi-asserted-by":"publisher","DOI":"10.1016\/j.ophtha.2016.02.022"},{"key":"2026050610200661000_bjo-2025-328621v1.9","doi-asserted-by":"crossref","first-page":"2805","DOI":"10.1038\/s41433-024-03172-4","article-title":"Correlation of limited-early-response status with 12-month CST, BVA, and machine learning-quantified retinal fluid in diabetic macular oedema in routine clinical practice","volume":"38","author":"Sastry","year":"2024","journal-title":"Eye (Lond)"},{"key":"2026050610200661000_bjo-2025-328621v1.10","doi-asserted-by":"crossref","first-page":"382","DOI":"10.1001\/jamaophthalmol.2018.6786","article-title":"Factors Associated With Visual Acuity and Central Subfield Thickness Changes When Treating Diabetic Macular Edema With Anti-Vascular Endothelial Growth Factor Therapy: An Exploratory Analysis of the Protocol T Randomized Clinical Trial","volume":"137","author":"Bressler","year":"2019","journal-title":"JAMA Ophthalmol"},{"key":"2026050610200661000_bjo-2025-328621v1.11","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajo.2004.12.054"},{"key":"2026050610200661000_bjo-2025-328621v1.12","doi-asserted-by":"publisher","DOI":"10.1016\/j.survophthal.2022.11.008"},{"key":"2026050610200661000_bjo-2025-328621v1.13","doi-asserted-by":"crossref","DOI":"10.1186\/s40942-023-00453-0","article-title":"Predictive factors for treatment outcomes with intravitreal anti-vascular endothelial growth factor injections in diabetic macular edema in clinical practice","volume":"9","author":"Gurung","year":"2023","journal-title":"Int J Retina Vitreous"},{"key":"2026050610200661000_bjo-2025-328621v1.14","doi-asserted-by":"crossref","first-page":"257","DOI":"10.1001\/jamaophthalmol.2017.6565","article-title":"Persistent Macular Thickening Following Intravitreous Aflibercept, Bevacizumab, or Ranibizumab for Central-Involved Diabetic Macular Edema With Vision Impairment: A Secondary Analysis of a Randomized Clinical Trial","volume":"136","author":"Bressler","year":"2018","journal-title":"JAMA Ophthalmol"},{"key":"2026050610200661000_bjo-2025-328621v1.15","doi-asserted-by":"publisher","DOI":"10.1097\/IAE.0b013e318296b271"},{"key":"2026050610200661000_bjo-2025-328621v1.16","doi-asserted-by":"publisher","DOI":"10.1016\/j.ophtha.2015.05.010"},{"key":"2026050610200661000_bjo-2025-328621v1.17","doi-asserted-by":"publisher","DOI":"10.1111\/aos.15309"},{"key":"2026050610200661000_bjo-2025-328621v1.18","unstructured":"National Health and Medical Research Council . National statement on ethical conduct in human research. 2023."},{"key":"2026050610200661000_bjo-2025-328621v1.19","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(22)00018-6"},{"key":"2026050610200661000_bjo-2025-328621v1.20","doi-asserted-by":"publisher","DOI":"10.1016\/j.ophtha.2017.03.057"},{"key":"2026050610200661000_bjo-2025-328621v1.21","doi-asserted-by":"crossref","first-page":"1153","DOI":"10.1016\/S0140-6736(23)02577-1","article-title":"Intravitreal aflibercept 8 mg in diabetic macular oedema (PHOTON): 48-week results from a randomised, double-masked, non-inferiority, phase 2\/3 trial","volume":"403","author":"Brown","year":"2024","journal-title":"Lancet"},{"key":"2026050610200661000_bjo-2025-328621v1.22","doi-asserted-by":"publisher","DOI":"10.1136\/bjophthalmol-2015-307249"},{"key":"2026050610200661000_bjo-2025-328621v1.23","doi-asserted-by":"publisher","DOI":"10.1016\/j.ophtha.2011.01.031"},{"key":"2026050610200661000_bjo-2025-328621v1.24","doi-asserted-by":"publisher","DOI":"10.1167\/iovs.18-25118"},{"key":"2026050610200661000_bjo-2025-328621v1.25","doi-asserted-by":"publisher","DOI":"10.1097\/00001648-199001000-00010"},{"key":"2026050610200661000_bjo-2025-328621v1.26","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2204225"},{"key":"2026050610200661000_bjo-2025-328621v1.27","doi-asserted-by":"crossref","DOI":"10.1136\/bmjophth-2019-000335","article-title":"Clinically meaningful visual improvements and predictors of early vision gains with ranibizumab for diabetic macular oedema","volume":"4","author":"Morse","year":"2019","journal-title":"BMJ Open Ophth"},{"key":"2026050610200661000_bjo-2025-328621v1.28","doi-asserted-by":"crossref","first-page":"2941","DOI":"10.1007\/s00417-021-05148-6","article-title":"Differences in the characteristics of subjects achieving complete, partial, or no resolution of macular edema in the READ-3 study","volume":"259","author":"Halim","year":"2021","journal-title":"Graefes Arch Clin Exp Ophthalmol"},{"key":"2026050610200661000_bjo-2025-328621v1.29","doi-asserted-by":"crossref","first-page":"64","DOI":"10.1038\/s41433-021-01624-9","article-title":"Evaluation of standard of care intravitreal aflibercept treatment of diabetic macular oedema treatment-naive patients in the UK: DRAKO study 12-month outcomes","volume":"36","author":"Sivaprasad","year":"2022","journal-title":"Eye (Lond)"},{"key":"2026050610200661000_bjo-2025-328621v1.30","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1007\/s40123-019-00224-x","article-title":"Clinical Outcomes of a Treat and Extend Regimen with Intravitreal Aflibercept Injections in Patients with Diabetic Macular Edema: Experience in Clinical Practice","volume":"9","author":"Curry","year":"2020","journal-title":"Ophthalmol Ther"},{"key":"2026050610200661000_bjo-2025-328621v1.31","doi-asserted-by":"publisher","DOI":"10.1016\/J.PRETEYERES.2023.101219"},{"key":"2026050610200661000_bjo-2025-328621v1.32","doi-asserted-by":"crossref","first-page":"278","DOI":"10.1001\/jamaophthalmol.2015.5346","article-title":"Persistent Macular Thickening After Ranibizumab Treatment for Diabetic Macular Edema With Vision Impairment","volume":"134","author":"Bressler","year":"2016","journal-title":"JAMA Ophthalmol"},{"key":"2026050610200661000_bjo-2025-328621v1.33","doi-asserted-by":"crossref","DOI":"10.1155\/2023\/6329819","article-title":"Diabetic Macular Oedema Guidelines: An Australian Perspective","volume":"2023","author":"Yuen","year":"2023","journal-title":"J Ophthalmol"},{"key":"2026050610200661000_bjo-2025-328621v1.34","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1186\/s40662-018-0119-9","article-title":"Evaluation of markers of outcome in real-world treatment of diabetic macular edema","volume":"5","author":"Campos","year":"2018","journal-title":"Eye Vis"},{"key":"2026050610200661000_bjo-2025-328621v1.35","doi-asserted-by":"crossref","DOI":"10.1038\/s41598-024-68552-y","article-title":"Evaluation of thickness of individual macular retinal layers in diabetic eyes from optical coherence tomography","volume":"14","author":"Shah","year":"2024","journal-title":"Sci Rep"}],"container-title":["British Journal of Ophthalmology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bjo-2025-328621","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,6]],"date-time":"2026-05-06T17:20:26Z","timestamp":1778088026000},"score":1,"resource":{"primary":{"URL":"https:\/\/bjo.bmj.com\/lookup\/doi\/10.1136\/bjo-2025-328621"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,6]]},"references-count":35,"alternative-id":["10.1136\/bjo-2025-328621"],"URL":"https:\/\/doi.org\/10.1136\/bjo-2025-328621","relation":{},"ISSN":["0007-1161","1468-2079"],"issn-type":[{"value":"0007-1161","type":"print"},{"value":"1468-2079","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,6]]}}}