Correlation between anterior chamber flare changes and diabetic macular edema after intravitreal injection of ranibizumab and aflibercept

Shiraya, Tomoyasu; Kure, Kana; Araki, Fumiyuki; Kato, Satoshi; Kaiya, Tadayoshi

doi:10.1007/s10384-019-00698-z

Cited by 8 publications

(5 citation statements)

References 31 publications

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“…We recently reported that CMT shows a significant correlation with the aqueous humor levels of various factors in DME patients [6]; this may partially explain why the change in aqueous flare value was the only independent determinant of the improvement in CMT after anti-VEGF therapy. In contrast to our findings, Shiraya et al [21] reported no correlation between changes in flare values and CMT in an IRI group. However, their study included patients who had received retinal photocoagulation and YAG capsulotomy in the 6 months before enrollment, and intravitreal injection of an antiangiogenic drug, or intravitreal or sub-Tenon injection of triamcinolone acetonide in the 3 months before enrollment.…”

Section: Discussioncontrasting

confidence: 99%

“…Even after several months, these treatments can affect cytokine levels [18]. Shiraya et al [21] also evaluated the correlation between the change rates in flare values and CMT 14 days after injection, unlike our evaluation which was carried out after 30 days. These differences between the study protocols might have contributed to the differences in results.…”

Section: Discussionmentioning

confidence: 99%

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Anti-VEGF Therapy Reduces Inflammation in Diabetic Macular Edema

et al. 2020

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Purpose: Correlations among the aqueous flare value (an indicator of inflammation), several functional-morphologic parameters, and aqueous humor levels of multiple cytokines or inflammatory factors were investigated in patients with diabetic macular edema (DME) receiving intravitreal ranibizumab injection (IRI). Methods: Aqueous humor levels of 12 cytokines, growth factors, or inflammatory factors were measured in 46 DME patients who received IRI. Vascular endothelial growth factor (VEGF), soluble VEGF receptor (sVEGFR), and the other cytokines/inflammatory factors were measured by the suspension array method. In addition, aqueous flare values were measured with a laser flare meter, and central macular thickness (CMT) was examined by optical coherence tomography. Results: At 1 month after IRI therapy, the aqueous flare value showed a significant decrease compared with before treatment (baseline). Significant correlations were noted between the aqueous flare value and the aqueous humor levels of 6 factors/cytokines, including sVEGFR-1, placental growth factor, monocyte chemoattractant protein 1, soluble intercellular adhesion molecule-1, interleukin (IL)-6, and interferon-inducible 10-kDa protein (IP-10). There was also a significant correlation between the change in aqueous flare value and improvement in CMT 1 month after IRI. Conclusions: These findings suggest that IRI reduces subclinical inflammation and that the aqueous flare value is influenced by inflammatory factors/cytokines. In addition, the change in the aqueous flare value may be an indicator of the response of CMT to IRI in patients with DME.

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Section: Discussioncontrasting

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Anti-VEGF Therapy Reduces Inflammation in Diabetic Macular Edema

et al. 2020

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“…There was no significant relationship between AFI values and percent change in CRT for any of the drugs. In our previous report, similar to Shiraya et al, there was a transient increase in AFI 1 day after aflibercept injection and no significant change in flare values before or after injection at 1 week or 1 month after either ranibizumab or aflibercept injection [ 24 , 25 ]. The reason for the dissociation of these data may be that the phakic and pseudophakic eyes were not analyzed separately in each report, and the periods between injection and measurement were not equal.…”

Section: Discussionsupporting

confidence: 67%

Flare levels after intravitreal injection of brolucizumab for diabetic macular edema

Ichihashi,

Takamura,

Hirano

et al. 2024

Graefes Arch Clin Exp Ophthalmol

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Purpose This study aimed to evaluate anterior flare intensity (AFI) after intravitreal injection of brolucizumab (IVBr) in patients with diabetic macular edema (DME), and to identify the factors associated with the change of AFI after IVBr. Methods This prospective multicenter study was conducted at five sites in Japan for patients with DME who underwent a single IVBr. AFI and central retinal thickness (CRT) were measured using a laser flare meter and spectral-domain optical coherence tomography, respectively, at weeks 0 and 6. Results Sixty-five patients (phakia, 37 eyes; pseudophakia, 28 eyes) were enrolled. Six weeks after IVBr, CRT and best-corrected visual acuity significantly improved (p < 0.0001). AFI (p = 0.0003) and age (p = 0.0054) were significantly higher in patients with pseudophakic eyes than those with phakic eyes. The AFI of the phakic eyes decreased after IVBr (p = 0.043). As the AFI before injection is higher (p = 0.0363) and the age is lower (p = 0.0016), the AFI decreases after IVBr. There was a significant positive correlation between the rates of change in CRT and AFI (p = 0.024). Conclusion After IVBr, AFI decreases in phakic eyes but not in pseudophakic eyes. The age, AFI and CRT before injection and changes of CRT are involved in the change in AFI after IVBr.

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“…The time point of interest for the clinical outcomes (BCVA and retinal thickness) was 12 months. The mean follow-up period in these studies ranged from 0.5 23 to 60 24 months.…”

Section: Resultsmentioning

confidence: 99%

“…The mean (±SD) age of the patients ranged from 52.6 (±14) 25 to 73.9 (±10) 23 years. The size of the study population varied widely, ranging from 14 26 to 2049 27 eyes.…”

Section: Resultsmentioning

confidence: 99%

Real-World Evidence in the Management of Diabetic Macular Edema with Intravitreal Anti-VEGFs in Asia: A Systematic Literature Review

Yuen¹,

Tan²,

Gan³

et al. 2022

OPTH

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Purpose To evaluate the visual outcomes and safety profile of intravitreal anti-vascular endothelial growth factor (anti-VEGF) therapy in the treatment of diabetic macular edema (DME) in real-world studies in Asian countries. Methods A systematic review of electronic literature databases (Embase, Medline, and the Cochrane Library from January 1, 2010, to March 16, 2021) was conducted to identify observational studies that reported clinical and safety outcomes of anti-VEGF treatments for DME in Asia. We analyzed baseline patient characteristics, treatment patterns, mean number of injections, best-corrected visual acuity (BCVA), retinal thickness, and safety outcomes. Results Seventy-one studies were included in this review. Most studies reported treatment of DME with ranibizumab (n = 33), followed by aflibercept (n = 13), bevacizumab (n = 28), and conbercept (n = 9). At 12 months, the cumulative mean number of injections for ranibizumab, aflibercept, and conbercept was 5.2, 4.6, and 6, respectively. At the 12-month follow-up, the cumulative mean BCVA gain was 6.8 letters (ranibizumab), 4.6 letters (aflibercept), 4.9 letters (bevacizumab), and 8.3 letters (conbercept). The cumulative mean reduction in retinal thickness at 12 months was 116.9 μm (ranibizumab), 105.9 μm (aflibercept), 81.7 μm (bevacizumab), and 135.2 μm (conbercept). A strong positive correlation (r = 0.78) was observed between mean number of injections and change in BCVA at 12 months. A moderate positive correlation (r = 0.54) was observed between mean number of injections and mean reduction in retinal thickness at 12 months. A weak positive correlation was observed between baseline retinal thickness and visual acuity at 12 months. Baseline BCVA and mean number of injections were predictors of BCVA at 12 months. Conclusion All anti-VEGFs were effective in the treatment of DME in Asia. The data suggest that a greater number of anti-VEGF injections was associated with better improvement in BCVA and moderate reduction in retinal thickness at the 1-year follow-up.

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Correlation between anterior chamber flare changes and diabetic macular edema after intravitreal injection of ranibizumab and aflibercept

Cited by 8 publications

References 31 publications

Anti-VEGF Therapy Reduces Inflammation in Diabetic Macular Edema

Anti-VEGF Therapy Reduces Inflammation in Diabetic Macular Edema

Flare levels after intravitreal injection of brolucizumab for diabetic macular edema

Real-World Evidence in the Management of Diabetic Macular Edema with Intravitreal Anti-VEGFs in Asia: A Systematic Literature Review

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