Functional and Anatomical Outcomes in Patients With Serous Retinal Detachment in Diabetic Macular Edema Treated With Ranibizumab

Giocanti-Aurégan, Audrey; Hrarat, Linda; Qu, Lise; Sarda, V.; Boubaya, Marouane; Lévy, Vincent; Chaîne, G.; Fajnkuchen, Franck

doi:10.1167/iovs.16-20855

Cited by 49 publications

(34 citation statements)

References 23 publications

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“…Some studies found worse outcomes or no difference [15-17], whereas others support the finding in this study that better visual acuity gain is associated with the presence of subretinal fluid at baseline [18, 19]. …”

Section: Discussionsupporting

confidence: 70%

One-Year Results of Using a Treat-and-Extend Regimen without a Loading Phase with Anti-VEGF Agents in Patients with Treatment-Naive Diabetic Macular Edema

et al. 2019

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Purpose: To evaluate real-life outcomes in treatment-naive patients with diabetic macular edema (DME) treated with anti-vascular endothelial growth factor (VEGF) agents using a treat-and-extend regimen without a fixed loading phase. Methods: Best-corrected visual acuity (BCVA) and central retinal thickness (CRT) measured using optical coherence tomography at baseline and after 1 year of treatment, intervals and number of injections were analyzed. Subgroup analysis was performed to compare anatomical and functional outcomes between patients receiving ranibizumab or aflibercept. Results: Seventy-five eyes of 61 patients met the inclusion criteria and had follow-up for 1 year. Baseline BCVA and CRT were 68.1 ± 13.2 letters and 424 ± 135 µm, retrospectively. After 1 year, there was a significant mean gain in BCVA of +5.8 ± 7.4 letters (paired t test: p < 0.0001) and a significant decrease in mean CRT of –117 ± 134 µm (paired t test: p < 0.0001). The mean number of anti-VEGF injections was 10.0 ± 1.6 (range 6–12). The mean maximum interval between injections was 8.5 ± 2.9 weeks (range 4–14) and the mean interval 6.0 ± 1.2 weeks (range 4.1–8.9). 96% of eyes could be extended after a mean of 5.3 injections and 17% of patients could be extended before reaching a formal loading dose of 3 injections. Subgroup analysis did not reveal any differences in outcomes between patients treated with ranibizumab or aflibercept. Subretinal fluid at baseline was associated with better BCVA gain after 1 year (stepwise forward regression analysis, p = 0.003). Conclusion: Our results suggest that not all patients with DME require a fixed loading phase when initiating anti-VEGF treatment. Finding anatomical predictors to identify this subgroup of patients would help to reduce treatment burden and optimize clinical outcomes.

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Section: Discussionsupporting

confidence: 70%

One-Year Results of Using a Treat-and-Extend Regimen without a Loading Phase with Anti-VEGF Agents in Patients with Treatment-Naive Diabetic Macular Edema

et al. 2019

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“…Accordingly, it might be implicated in the regulation of this important physiological barrier and in the occurrence of macular edema, and in particular with the DME subtype associated with SRD. Although the pathogenetic theories at the basis of SRD occurrence are different, the role of RPE in retinal fluid homeostasis seems to be clinically confirmed by the results of the present series, since the DME patients showed a SRD incidence of 42%, which is in the high range compared to the 15%–45% reported in the literature [ 38 , 39 , 40 ]. However, we failed to demonstrate a significant differential expression of each of the downregulated miRNAs, including miR-199a-3p, between patients with and without SRD.…”

Section: Discussionsupporting

confidence: 83%

MicroRNA Expression in the Aqueous Humor of Patients with Diabetic Macular Edema

Grieco

Sebastiani

Eandi

et al. 2020

IJMS

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We identified and compared secreted microRNA (miRNA) expression in aqueous humor (AH) and plasma samples among patients with: type 2 diabetes mellitus (T2D) complicated by non-proliferative diabetic retinopathy (DR) associated with diabetic macular edema (DME) (DME group: 12 patients); T2D patients without DR (D group: 8 patients); and non-diabetic patients (CTR group: 10 patients). Individual patient AH samples from five subjects in each group were profiled on TaqMan Low Density MicroRNA Array Cards. Differentially expressed miRNAs identified from profiling were then validated in single assay for all subjects. The miRNAs validated in AH were then evaluated in single assay in plasma. Gene Ontology (GO) analysis was conducted. From AH profiling, 119 mature miRNAs were detected: 86 in the DME group, 113 in the D group and 107 in the CTR group. miRNA underexpression in the DME group was confirmed in single assay for let-7c-5p, miR-200b-3p, miR-199a-3p and miR-365-3p. Of these four, miR-199a-3p and miR-365-3p were downregulated also in the plasma of the DME group. GO highlighted 54 validated target genes of miR-199a-3p, miR-200b-3p and miR-365-3p potentially implied in DME pathogenesis. Although more studies are needed, miR-200b-3p, let-7c-5p, miR-365-3p and miR-199a-3p represent interesting molecules in the study of DME pathogenesis.

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“…Determination of the morphologic and topographic characteristics of ME may help in elucidating the pathophysiology of the disease, which in turn helps predict the treatment response. [14][15][16][17] The morphologic features of ME on spectraldomain optical coherence tomography (SD-OCT) might be classified into three major types: diffuse retinal thickening (DRT), cystoid ME (CME), and serous retinal detachment. 18,19 Seo et al 20 reported that DRT showed a particularly good response to ranibizumab with fewer injections.…”

mentioning

confidence: 99%

Association Between Hyperreflective Dots on Spectral-Domain Optical Coherence Tomography in Macular Edema and Response to Treatment

Hwang

Chae

Kim

et al. 2017

Invest. Ophthalmol. Vis. Sci.

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In patients with DME or macular edema due to RVO, the number of HRDs on SD-OCT may be a predictive indicator of the response to IVB injection or dexamethasone implant. In bevacizumab responders, the number of HRDs on SD-OCT was small. In contrast, more HRDs, which might reflect increased inflammation in the retina, were observed in dexamethasone responders. Therefore, dexamethasone implants might be more effective in DME or RVO eyes with multiple HRDs and OPL disruption on SD-OCT.

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Functional and Anatomical Outcomes in Patients With Serous Retinal Detachment in Diabetic Macular Edema Treated With Ranibizumab

Abstract: Similar BCVA gains were observed regardless of the presence of SRD. The higher visual gain usually observed in DME with SRD could be associated with a lower baseline BCVA.

Cited by 49 publications

References 23 publications

One-Year Results of Using a Treat-and-Extend Regimen without a Loading Phase with Anti-VEGF Agents in Patients with Treatment-Naive Diabetic Macular Edema

One-Year Results of Using a Treat-and-Extend Regimen without a Loading Phase with Anti-VEGF Agents in Patients with Treatment-Naive Diabetic Macular Edema

MicroRNA Expression in the Aqueous Humor of Patients with Diabetic Macular Edema

Association Between Hyperreflective Dots on Spectral-Domain Optical Coherence Tomography in Macular Edema and Response to Treatment

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