Baseline predictors for visual acuity loss during observation in diabetic macular oedema with good baseline visual acuity.
Angiogenesis Inhibitors
/ administration & dosage
Bevacizumab
/ administration & dosage
Diabetic Retinopathy
/ diagnosis
Female
Fluorescein Angiography
/ methods
Follow-Up Studies
Fundus Oculi
Humans
Macular Edema
/ diagnosis
Male
Middle Aged
Ranibizumab
/ administration & dosage
Retrospective Studies
Tomography, Optical Coherence
/ methods
Treatment Outcome
Vascular Endothelial Growth Factor A
/ antagonists & inhibitors
Visual Acuity
diabetes
diabetic macular oedema
diabetic retinopathy
good visual acuity
intravitreal therapy
macular oedema
observation
Journal
Acta ophthalmologica
ISSN: 1755-3768
Titre abrégé: Acta Ophthalmol
Pays: England
ID NLM: 101468102
Informations de publication
Date de publication:
Nov 2020
Nov 2020
Historique:
received:
13
08
2019
revised:
04
02
2020
accepted:
09
02
2020
pubmed:
3
3
2020
medline:
6
7
2021
entrez:
3
3
2020
Statut:
ppublish
Résumé
To investigate clinical baseline characteristics and optical coherence tomography biomarkers predicting visual loss during observation in eyes with diabetic macular oedema (DMO) and good baseline visual acuity (VA). A sub-analysis of a 12-month, retrospective study, including patients with baseline VA ≤0.1 logMAR (≥20/25 Snellen) and centre-involving DMO. The primary outcome measure was the correlation between baseline characteristics and VA loss ≥10 letters during follow-up. A total of 249 eyes were included in the initial study, of which 147 eyes were observed and 80 eyes received anti-vascular endothelial growth factor (VEGF) treatment at baseline. Visual acuity (VA) loss ≥10 letters occurred in 21.8% (observed cohort) and in 24.3% (treated cohort), respectively. Within observed eyes, presence of hyperreflective foci [HRF; odds ratio (OR): 3.18, p = 0.046], and disorganization of inner retina layers (DRIL; OR: 2.71, p = 0.026) were associated with a higher risk of VA loss ≥10 letters. In observed eyes with a combined presence of HRF, DRIL and ellipsoid zone (EZ) disruption, the risk of VA loss was further increased (OR: 3.86, p = 0.034). In eyes with combined presence of DRIL, HRF and EZ disruption, risk of VA loss was 46.7% (7/15 eyes) in the observed cohort, and 26.3% (5/19 eyes) in the treated cohort (p = 0.26). Patients with DMO and good baseline VA, managed by observation, are of increased risk for VA loss if DRIL, HRF and EZ disruption are present at baseline. Earlier treatment with anti-VEGF in these patients may potentially decrease the risk of VA loss at 12 months.
Substances chimiques
Angiogenesis Inhibitors
0
Vascular Endothelial Growth Factor A
0
Bevacizumab
2S9ZZM9Q9V
Ranibizumab
ZL1R02VT79
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
e801-e806Informations de copyright
© 2020 The Authors. Acta Ophthalmologicas published by John Wiley & Sons Ltd on behalf of Acta Ophthalmologica Scandinavica Foundation.
Références
Arroba AI & Valverde AM (2017): Modulation of microglia in the retina: new insights into diabetic retinopathy. Acta Diabetol 54: 527-533.
Baker CW, Glassman AR, Beaulieu WT et al. (2019): Effect of initial management with aflibercept vs laser photocoagulation vs observation on vision loss among patients with diabetic macular edema involving the center of the macula and good visual acuity. JAMA 321: 1880.
Boyer DS, Yoon YH, Belfort R Jr et al. (2014): Three-year, randomized, sham-controlled trial of dexamethasone intravitreal implant in patients with diabetic macular edema. Ophthalmology 121: 1904-1914.
Bressler SB, Qin H, Beck RW, Chalam KV, Kim JE, Melia M, Wells JA 3rd; Diabetic Retinopathy Clinical Research Network (2012): Factors associated with changes in visual acuity and central subfield thickness at 1 year after treatment for diabetic macular edema with ranibizumab. Arch Ophthalmol 130: 1153-1161.
Busch C, Fraser-Bell S, Zur D et al. (2019): Real-world outcomes of observation and treatment in diabetic macular edema with very good visual acuity: the OBTAIN study. Acta Diabetol 56: 777-784.
Channa R, Sophie R, Khwaja AA, Do DV, Hafiz G, Nguyen QD, Campochiaro PA; READ-2 Study Group (2014): Factors affecting visual outcomes in patients with diabetic macular edema treated with ranibizumab. Eye 28: 269-278.
De Benedetto U, Sacconi R, Pierro L, Lattanzio R & Bandello F (2015): Optical coherence tomographic hyperreflective foci in early stages of diabetic retinopathy. Retina 35: 449-453.
Figueira J, Khan J, Nunes S, Sivaprasad S, Rosa A, de Abreu JF, Cunha-Vaz JG & Chong NV (2009): Prospective randomised controlled trial comparing sub-threshold micropulse diode laser photocoagulation and conventional green laser for clinically significant diabetic macular oedema. Br J Ophthalmol 93: 1341-1344.
Gillies MC, Lim LL, Campain A et al. (2014): A randomized clinical trial of intravitreal bevacizumab versus intravitreal dexamethasone for diabetic macular edema: the BEVORDEX study. Ophthalmology 121: 2473-2481.
Joltikov KA, Sesi CA, de Castro VM et al. (2018): Disorganization of retinal inner layers (DRIL) and neuroretinal dysfunction in early diabetic retinopathy. Invest Ophthalmol Vis Sci 59: 5481-5486.
Maheshwary AS, Oster SF, Yuson RM, Cheng L, Mojana F & Freeman WR (2010): The association between percent disruption of the photoreceptor inner segment-outer segment junction and visual acuity in diabetic macular edema. Am J Ophthalmol 150: 63-67.e61.
Midena E, Pilotto E & Bini S (2018): Hyperreflective intraretinal foci as an OCT biomarker of retinal inflammation in diabetic macular edema. Invest Ophthalmol Vis Sci 59: 5366.
Nguyen QD, Brown DM, Marcus DM et al. (2012): Ranibizumab for diabetic macular edema: results from 2 phase III randomized trials: RISE and RIDE. Ophthalmology 119: 789-801.
Nicholson L, Ramu J, Triantafyllopoulou I, Patrao NV, Comyn O, Hykin P & Sivaprasad S (2015): Diagnostic accuracy of disorganization of the retinal inner layers in detecting macular capillary non-perfusion in diabetic retinopathy. Clin Exp Ophthalmol 43: 735-741.
Santos AR, Costa MA, Schwartz C, Alves D, Figueira J, Silva R & Cunha-Vaz JG (2018): Optical coherence tomography baseline predictors for initial best-corrected visual acuity response to intravitreal anti-vascular endothelial growth factor treatment in eyes with diabetic macular edema: the Chartres Study. Retina 38: 1110-1119.
Schreur V, Altay L, van Asten F, Groenewoud JMM, Fauser S, Klevering BJ, Hoyng CB & de Jong EK (2018): Hyperreflective foci on optical coherence tomography associate with treatment outcome for anti-VEGF in patients with diabetic macular edema. PLoS ONE 13: e0206482.
Seo KH, Yu SY, Kim M & Kwak HW (2016): Visual and morphologic outcomes of intravitreal ranibizumab for diabetic macular edema based on optical coherence tomography patterns. Retina 36: 588-595.
Sivaprasad S, Crosby-Nwaobi R, Heng LZ, Peto T, Michaelides M & Hykin P (2013): Injection frequency and response to bevacizumab monotherapy for diabetic macular oedema (BOLT Report 5). Br J Ophthalmol 97: 1177-1180.
Sophie R, Lu N & Campochiaro PA (2015): Predictors of functional and anatomic outcomes in patients with diabetic macular edema treated with ranibizumab. Ophthalmology 122: 1395-1401.
Sun JK, Lin MM, Lammer J, Prager S, Sarangi R, Silva PS & Aiello LP (2014): Disorganization of the retinal inner layers as a predictor of visual acuity in eyes with center-involved diabetic macular edema. JAMA Ophthalmol 132: 1309-1316.
Vujosevic S, Bini S, Midena G, Berton M, Pilotto E & Midena E (2013): Hyperreflective intraretinal spots in diabetics without and with nonproliferative diabetic retinopathy: an in vivo study using spectral domain OCT. J Diabetes Res 2013: 491835.
Vujosevic S, Berton M, Bini S, Casciano M, Cavarzeran F & Midena E (2016): Hyperreflective retinal spots and visual function after anti-vascular endothelial growth factor treatment in center-involving diabetic macular edema. Retina 36: 1298-1308.
Vujosevic S, Bini S, Torresin T et al. (2017): Hyperreflective retinal spots in normal and diabetic eyes: B-scan and en face spectral domain optical coherence tomography evaluation. Retina 37: 1092-1103.
Vujosevic S, Torresin T, Bini S, Convento E, Pilotto E, Parrozzani R & Midena E (2017): Imaging retinal inflammatory biomarkers after intravitreal steroid and anti-VEGF treatment in diabetic macular oedema. Acta Ophthalmol 95: 464-471.
Wells JA, Glassman AR, Ayala AR et al. (2016): Aflibercept, bevacizumab, or ranibizumab for diabetic macular edema: two-year results from a comparative effectiveness randomized clinical trial. Ophthalmology 123: 1351-1359.
Yau JW, Rogers SL, Kawasaki R et al. (2012): Global prevalence and major risk factors of diabetic retinopathy. Diabetes Care 35: 556-564.
Zur D, Iglicki M, Busch C, Invernizzi A, Mariussi M & Loewenstein A; International Retina Group (2018a): Optical coherence tomography biomarkers as functional outcome predictors in diabetic macular edema treated with dexamethasone implant. Ophthalmology 125: 267-275.
Zur D, Iglicki M, Feldinger L, Schwartz S, Goldstein M, Loewenstein A & Barak A (2018b): Disorganization of retinal inner layers as a biomarker for idiopathic epiretinal membrane after macular surgery-the DREAM study. Am J Ophthalmol 196: 129-135.