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Angiographic biomarkers are significant predictors of treatment response to intravitreal aflibercept in diabetic macular edema

This prospective single-center study aims to identify biomarkers that predict improvement in best-corrected visual acuity (BCVA) and central retinal thickness (CRT) at 6 months, in 76 eyes with diabetic macular edema (DME) treated monthly with intravitreal aflibercept. At baseline, all patients unde...

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Autores principales: Hein, Martin, Vukmirovic, Aleksandar, Constable, Ian J., Raja, Vignesh, Athwal, Arman, Freund, K. Bailey, Balaratnasingam, Chandrakumar
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Nature Publishing Group UK 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10199070/
https://www.ncbi.nlm.nih.gov/pubmed/37208427
http://dx.doi.org/10.1038/s41598-023-35286-2
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author Hein, Martin
Vukmirovic, Aleksandar
Constable, Ian J.
Raja, Vignesh
Athwal, Arman
Freund, K. Bailey
Balaratnasingam, Chandrakumar
author_facet Hein, Martin
Vukmirovic, Aleksandar
Constable, Ian J.
Raja, Vignesh
Athwal, Arman
Freund, K. Bailey
Balaratnasingam, Chandrakumar
author_sort Hein, Martin
collection PubMed
description This prospective single-center study aims to identify biomarkers that predict improvement in best-corrected visual acuity (BCVA) and central retinal thickness (CRT) at 6 months, in 76 eyes with diabetic macular edema (DME) treated monthly with intravitreal aflibercept. At baseline, all patients underwent standardized imaging with color photography, optical coherence tomography (OCT), fluorescein angiography (FA) and OCT angiography (OCTA). Glycosylated hemoglobin, renal function, dyslipidemia, hypertension, cardiovascular disease and smoking were recorded. Retinal images were graded in a masked fashion. Baseline imaging, systemic and demographic variables were investigated to detect associations to BCVA and CRT change post aflibercept. Predictors of BCVA improvement included greater macular vessel density quantified using OCTA (p = 0.001) and low-density lipoprotein (LDL) ≥ 2.6 mmol/L (p = 0.017). Lower macular vessel density eyes showed a significant reduction in CRT but no BCVA improvement. Predictors of CRT reduction included peripheral non-perfusion seen on ultrawide-field FA (p = 0.005) and LDL ≥ 2.6 mmol/L (p < 0.001). Retinal angiographic biomarkers derived from OCTA and ultrawide-field FA may help predict functional and anatomic response to anti-vascular endothelial growth factor (VEGF) therapy in patients with DME. Elevated LDL is associated with treatment response in DME. These results may be used to better-select patients who will benefit from intravitreal aflibercept for treatment of DME.
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spelling pubmed-101990702023-05-21 Angiographic biomarkers are significant predictors of treatment response to intravitreal aflibercept in diabetic macular edema Hein, Martin Vukmirovic, Aleksandar Constable, Ian J. Raja, Vignesh Athwal, Arman Freund, K. Bailey Balaratnasingam, Chandrakumar Sci Rep Article This prospective single-center study aims to identify biomarkers that predict improvement in best-corrected visual acuity (BCVA) and central retinal thickness (CRT) at 6 months, in 76 eyes with diabetic macular edema (DME) treated monthly with intravitreal aflibercept. At baseline, all patients underwent standardized imaging with color photography, optical coherence tomography (OCT), fluorescein angiography (FA) and OCT angiography (OCTA). Glycosylated hemoglobin, renal function, dyslipidemia, hypertension, cardiovascular disease and smoking were recorded. Retinal images were graded in a masked fashion. Baseline imaging, systemic and demographic variables were investigated to detect associations to BCVA and CRT change post aflibercept. Predictors of BCVA improvement included greater macular vessel density quantified using OCTA (p = 0.001) and low-density lipoprotein (LDL) ≥ 2.6 mmol/L (p = 0.017). Lower macular vessel density eyes showed a significant reduction in CRT but no BCVA improvement. Predictors of CRT reduction included peripheral non-perfusion seen on ultrawide-field FA (p = 0.005) and LDL ≥ 2.6 mmol/L (p < 0.001). Retinal angiographic biomarkers derived from OCTA and ultrawide-field FA may help predict functional and anatomic response to anti-vascular endothelial growth factor (VEGF) therapy in patients with DME. Elevated LDL is associated with treatment response in DME. These results may be used to better-select patients who will benefit from intravitreal aflibercept for treatment of DME. Nature Publishing Group UK 2023-05-19 /pmc/articles/PMC10199070/ /pubmed/37208427 http://dx.doi.org/10.1038/s41598-023-35286-2 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Article
Hein, Martin
Vukmirovic, Aleksandar
Constable, Ian J.
Raja, Vignesh
Athwal, Arman
Freund, K. Bailey
Balaratnasingam, Chandrakumar
Angiographic biomarkers are significant predictors of treatment response to intravitreal aflibercept in diabetic macular edema
title Angiographic biomarkers are significant predictors of treatment response to intravitreal aflibercept in diabetic macular edema
title_full Angiographic biomarkers are significant predictors of treatment response to intravitreal aflibercept in diabetic macular edema
title_fullStr Angiographic biomarkers are significant predictors of treatment response to intravitreal aflibercept in diabetic macular edema
title_full_unstemmed Angiographic biomarkers are significant predictors of treatment response to intravitreal aflibercept in diabetic macular edema
title_short Angiographic biomarkers are significant predictors of treatment response to intravitreal aflibercept in diabetic macular edema
title_sort angiographic biomarkers are significant predictors of treatment response to intravitreal aflibercept in diabetic macular edema
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10199070/
https://www.ncbi.nlm.nih.gov/pubmed/37208427
http://dx.doi.org/10.1038/s41598-023-35286-2
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