# Differentiating treatment episodes from gaps in eyes with diabetic macular oedema

## TL;DR

This study uses an algorithm to identify treatment episodes and gaps in diabetic macular oedema patients based on injection intervals.

## Contribution

The study introduces a novel method using isolation forests to differentiate treatment episodes from gaps in DMO treatment.

## Key findings

- A gap of ≥38 weeks between injections was identified as a treatment gap.
- The method allows for more accurate characterization of DMO treatment patterns.

## Abstract

The treatment of diabetic macular oedema (DMO) likely involves a series of treatment episodes separated by gaps during which no vascular endothelial growth factor inhibitor injections are delivered. Our aim is to differentiate the episodes and gaps with the isolation forests algorithm using the Fight Retinal Blindness! registry. We analysed 11 786 injection intervals (12 803 injections) and found that the period between adjacent injections≥38 weeks (95% CI 34 to 43 weeks) apart could be regarded as a treatment gap. The results will allow treatment episodes to be isolated so that the treatment patterns of DMO can be characterised more accurately.