Optical Coherence Tomography Biomarkers in Bilateral Diabetic Macular Edema Patients with Asymmetric anti-VEGF Response

Koç, Feray; Güven, Yusuf Ziya; Eğrilmez, Deniz; Aydın, Erdinç

doi:10.1080/08820538.2021.1907423

Cited by 8 publications

(6 citation statements)

References 45 publications

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“…A growing number of studies today have attempted to use spectral domain optical coherence tomography based (SD-OCT based) imaging biomarkers for diagnosis, monitoring and treatment-prediction of DME. The biomarkers include retinal hyper-reflective foci [14][15][16][17][18][19], presence of disorganization of the inner retinal layers [20] [21,22], disruption of ellipsoid zone [12,[23][24][25], disruption of external limiting membrane [13,23,26,27], vitreo-macular status [28], and intra-retinal cyst [29]. Response to anti-VEGF injections has also been reported to be influenced by different morphological subtypes of DME, with the sub-type diffuse retinal thickening showing the least improvement and serous retinal detachment showing the most improvement [30].…”

Section: Introductionmentioning

confidence: 99%

“…Most studies on predictors of treatment response are from post-hoc analysis of randomized trials [6,7,9,10,26,[36][37][38][39][40][41], with limited studies from real-world practice exclusively designed to examine the prognostic factors [11,12,42]. The majority of the real-world studies were retrospective [11,43], performed at a single medical center [20,23], had limited sample size (sample size as low as 15 eyes) [28,32], and limited follow-up [23,32]. An additional issue with these studies is the lack of consistency in results across studies, such as hyper-reflective foci being a favourable predictor by some [43,44] and a negative predictor by others [45,46].…”

Section: Introductionmentioning

confidence: 99%

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Predictive factors for treatment outcomes with intravitreal anti-vascular endothelial growth factor injections in diabetic macular edema in clinical practice

et al. 2023

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Background Intravitreal anti-vascular endothelial growth factor (anti-VEGF) injections are the standard of care for diabetic macular edema (DME), a common complication of diabetes. This study aimed to identify factors influencing DME intravitreal anti-VEGF treatment outcomes in real-world practice. Methods This was a multi-center retrospective observational study using medical chart review of participants receiving anti-VEGF injections for DME (N = 248). Demographic and clinical variables were assessed for association with best corrected visual acuity (BCVA) and central macular thickness (CMT) outcomes using regression models. Results There was a significant improvement in BCVA (p < 0.001) and CMT (p < 0.001) after 12 months of treatment, although 21% of participants had decreased BCVA, and 41% had a < 10% CMT reduction at 12 months. Higher baseline BCVA (p = 0.022, OR=-0.024, 95% CI=-0.046,-0.004) and longer duration of diabetic retinopathy (p = 0.048, OR=-0.064, 95% CI=-0.129,-0.001) were negative predictors for BCVA response, whereas Aflibercept treatment (p = 0.017, OR = 1.107, 95% CI = 0.220,2.051) compared with other drugs and a positive “early functional response” (p < 0.001, OR=-1.393, 95% CI=-1.946,-0.857) were positive predictors. A higher baseline CMT (p < 0.001, OR = 0.019, 95% CI = 0.012,0.0261) and an “early anatomical response”, (p < 0.001, OR=-1.677, 95% CI=-2.456, -0.943) were predictors for greater reduction in CMT. Overall, the variables could predict only 23% of BCVA and 52% of CMT response. Conclusions The study shows a significant proportion of DME patients do not respond to anti-VEGF therapy and identifies several clinical predictors for treatment outcomes. Trial registration The study was approved through the Human Research Ethics Committee, University of Tasmania (approval number H0012902), and the Southern Adelaide Clinical Human Research Ethics Committee (approval number 86 − 067).

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Predictive factors for treatment outcomes with intravitreal anti-vascular endothelial growth factor injections in diabetic macular edema in clinical practice

et al. 2023

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“…Retinal therapies considered in the studies found included panretinal photocoagulation, 180 anti-VEGF, 181 , 182 , 183 , 184 , 185 , 186 , 187 , 188 , 189 , 190 , 191 , 192 , 193 , 194 , 195 , 196 , 197 , 198 , 199 , 200 , 201 , 202 , 203 , 204 , 205 , 206 , 207 , 208 , 209 , 210 , 211 , 212 , 213 pars plana vitrectomy, 214 and steroids 215 , 216 , 217 for DME 181 , 182 , 183 , 185 , 187 , 188 , 191 , 192 , 194 , 195 , 196 , 197 , 198 , 199 , 200 , 201 , 202 , 203 , 204 , 205 , 206 , 207 , 208 , 210 , 212 , 213 , 214 <...…”

Section: Resultsmentioning

confidence: 99%

Role of Systemic Factors in Improving the Prognosis of Diabetic Retinal Disease and Predicting Response to Diabetic Retinopathy Treatment

Mellor,

Jeyam,

Beulens

et al. 2024

Ophthalmology Science

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“…The disruption of the BRB, intricate subcellular mechanisms (increased oxidative stress by reactive oxygen species, cellular signaling), associated vascular risk factors (atherosclerosis), as well as the clinical course of the disease and other unknown factors could possibly influence the rate of development and severity of DME or DR in one eye more than in the contralateral one [ 38 , 39 ]. On the other hand, studies have shown that anti-VEGF treatment for DME in one eye influenced positively the fellow eye, having good results at follow-up [ 40 ].…”

Section: Discussionmentioning

confidence: 99%

Interleaved Optical Coherence Tomography: Clinical and Laboratory Biomarkers in Patients with Diabetic Macular Edema

Suciu

Nicoară

2022

JPM

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(1) Background: The global burden of diabetes mellitus (DM) has been estimated to reach 600 million patients worldwide by 2040. Approximately 200 million people will develop diabetic retinopathy within this time frame. Diabetic macular edema (DME) is a severe, vision-threatening complication that can develop at any stage of diabetic retinopathy, and it represents the main cause of vision loss in patients with DM. Its harmful consequences on visual function could be prevented with timely recognition and treatment. (2) Methods: This study assessed the clinical (demographic characteristics, diabetic evolution, and systemic vascular complications); laboratory (glycated hemoglobin, metabolic parameters, capillary oxygen saturation, and renal function); ophthalmologic exam; and spectral-domain optical coherence tomography (SD–OCT) (macular volume, central macular thickness, maximal central thickness, minimal central thickness, foveal thickness, superior inner, inferior inner, nasal inner, temporal inner, inferior outer, superior outer, nasal outer, and temporal outer thicknesses, disruption of the ellipsoid zone, and disruption of the inner retinal layers (DRIL) parameters in three groups of individuals: healthy controls (HC), patients with DME and type 1 DM (T1DM—group A), and patients with DME and type 2 DM (T2DM—group B) to identify novel correlations between them that would open a path to new pathogenetic hypotheses and, implicitly, to the identification of new therapeutic methods, as part of a tailored treatment within the concept of precision medicine. (3) Results: The duration of DM was significantly longer in group A as compared with group B, as were the prevalence of smoking and systemic vascular complications. Capillary oxygen saturation and estimated glomerular filtration rates were significantly lower, and serum creatinine levels were significantly higher in group A as compared to group B. Regarding the OCT findings, DME had a predominantly eccentric pattern, and the right eye was more severely affected in both groups of patients. Significantly higher values were obtained in group B as compared to group A for the following OCT biomarkers: macular volume, central macular thickness, maximal central thickness, minimal central thickness, foveal thickness, superior inner, inferior inner, nasal inner, inferior outer and nasal outer thickness. The disruption of the ellipsoid zone was significantly more prevalent within group A, whereas the overall disruption of the retinal inner layers (DRIL) was identified significantly more frequently in group B. (4) Conclusions: Whereas systemic and laboratory biomarkers were more severely affected in patients with DME and T1DM, the OCT quantitative biomarkers revealed significantly higher values in patients with DME and T2DM.

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Optical Coherence Tomography Biomarkers in Bilateral Diabetic Macular Edema Patients with Asymmetric anti-VEGF Response

Cited by 8 publications

References 45 publications

Predictive factors for treatment outcomes with intravitreal anti-vascular endothelial growth factor injections in diabetic macular edema in clinical practice

Predictive factors for treatment outcomes with intravitreal anti-vascular endothelial growth factor injections in diabetic macular edema in clinical practice

Role of Systemic Factors in Improving the Prognosis of Diabetic Retinal Disease and Predicting Response to Diabetic Retinopathy Treatment

Interleaved Optical Coherence Tomography: Clinical and Laboratory Biomarkers in Patients with Diabetic Macular Edema

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