Cargando…
Factors associated with 1-year visual response following intravitreal bevacizumab treatment for diabetic macular edema: a retrospective single center study
BACKGROUND: To explore the association of clinical characteristics and retinal microstructural features on optical coherence tomography in predicting 1-year visual response following intravitreal bevacizumab injections in eyes with visual impairment from center-involved diabetic macular edema (CI-DM...
Autores principales: | , , , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2021
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7931592/ https://www.ncbi.nlm.nih.gov/pubmed/33663604 http://dx.doi.org/10.1186/s40942-021-00286-9 |
_version_ | 1783660326950010880 |
---|---|
author | Choovuthayakorn, Janejit Tantraworasin, Apichat Phinyo, Phichayut Patumanond, Jayanton Kunavisarut, Paradee Srisomboon, Titipol Winaikosol, Pawara Patikulsila, Direk Chaikitmongkol, Voraporn Watanachai, Nawat Pathanapitoon, Kessara |
author_facet | Choovuthayakorn, Janejit Tantraworasin, Apichat Phinyo, Phichayut Patumanond, Jayanton Kunavisarut, Paradee Srisomboon, Titipol Winaikosol, Pawara Patikulsila, Direk Chaikitmongkol, Voraporn Watanachai, Nawat Pathanapitoon, Kessara |
author_sort | Choovuthayakorn, Janejit |
collection | PubMed |
description | BACKGROUND: To explore the association of clinical characteristics and retinal microstructural features on optical coherence tomography in predicting 1-year visual response following intravitreal bevacizumab injections in eyes with visual impairment from center-involved diabetic macular edema (CI-DME). METHODS: Medical records of patients with visual impairment from CI-DME, who initiated intravitreal bevacizumab injections between Jan 2012 and Dec 2016 and were followed for a minimum of 12 months were retrospectively reviewed. RESULTS: The study included 226 eyes with a mean (SD) baseline visual acuity (VA) of 51.8 (19.1) letters. At week 12, following the three initial treatments, a mean (SD) VA improved to 61.7 (17.8) letters. Visual gain ≥ 10 letters was observed in 109 eyes (48.2%), while a limited early visual gain < 5 letters was noted in 80 eyes (35.4%). At one year, 110 eyes (48.7%) achieved a good VA gain ≥ 10 letters. In addition, eyes with poor baseline VA had a higher proportion of eyes that obtained limited early VA gained at week 12 (< 5 letters) and maintained in this visual response category at moth 12 compared to eyes with better baseline VA (74.1% versus 59.1%). In the multivariable logistic regression, the following factors reduced the probability of 1-year visual gain ≥ 10 letters: elderly (p = 0.040), better baseline vision (p = 0.001), and limited early visual gain < 5 letters at week 12 (p < 0.001). In multivariable linear regression, male (p = 0.010) and eyes with the presence of hyperreflective foci on baseline OCT (p = 0.010) were likely to have higher VA improvement. However, eyes with better baseline VA (p = 0.002), limited early VA gain at week 12 (p < 0.001), and a presence of EZ disruption at week 12 (p = 0.002) were likely to have less VA improvement. CONCLUSIONS: Although bevacizumab is considered as effective management for CI-DME, variability in treatment responses is expected. This study revealed that baseline characteristics and visual responses at week 12 might help predict the long-term treatment response. Eyes with characteristics at risk of limited long-term visual outcome may require attention in optimizing their individual treatment strategies. |
format | Online Article Text |
id | pubmed-7931592 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-79315922021-03-05 Factors associated with 1-year visual response following intravitreal bevacizumab treatment for diabetic macular edema: a retrospective single center study Choovuthayakorn, Janejit Tantraworasin, Apichat Phinyo, Phichayut Patumanond, Jayanton Kunavisarut, Paradee Srisomboon, Titipol Winaikosol, Pawara Patikulsila, Direk Chaikitmongkol, Voraporn Watanachai, Nawat Pathanapitoon, Kessara Int J Retina Vitreous Original Article BACKGROUND: To explore the association of clinical characteristics and retinal microstructural features on optical coherence tomography in predicting 1-year visual response following intravitreal bevacizumab injections in eyes with visual impairment from center-involved diabetic macular edema (CI-DME). METHODS: Medical records of patients with visual impairment from CI-DME, who initiated intravitreal bevacizumab injections between Jan 2012 and Dec 2016 and were followed for a minimum of 12 months were retrospectively reviewed. RESULTS: The study included 226 eyes with a mean (SD) baseline visual acuity (VA) of 51.8 (19.1) letters. At week 12, following the three initial treatments, a mean (SD) VA improved to 61.7 (17.8) letters. Visual gain ≥ 10 letters was observed in 109 eyes (48.2%), while a limited early visual gain < 5 letters was noted in 80 eyes (35.4%). At one year, 110 eyes (48.7%) achieved a good VA gain ≥ 10 letters. In addition, eyes with poor baseline VA had a higher proportion of eyes that obtained limited early VA gained at week 12 (< 5 letters) and maintained in this visual response category at moth 12 compared to eyes with better baseline VA (74.1% versus 59.1%). In the multivariable logistic regression, the following factors reduced the probability of 1-year visual gain ≥ 10 letters: elderly (p = 0.040), better baseline vision (p = 0.001), and limited early visual gain < 5 letters at week 12 (p < 0.001). In multivariable linear regression, male (p = 0.010) and eyes with the presence of hyperreflective foci on baseline OCT (p = 0.010) were likely to have higher VA improvement. However, eyes with better baseline VA (p = 0.002), limited early VA gain at week 12 (p < 0.001), and a presence of EZ disruption at week 12 (p = 0.002) were likely to have less VA improvement. CONCLUSIONS: Although bevacizumab is considered as effective management for CI-DME, variability in treatment responses is expected. This study revealed that baseline characteristics and visual responses at week 12 might help predict the long-term treatment response. Eyes with characteristics at risk of limited long-term visual outcome may require attention in optimizing their individual treatment strategies. BioMed Central 2021-03-04 /pmc/articles/PMC7931592/ /pubmed/33663604 http://dx.doi.org/10.1186/s40942-021-00286-9 Text en © The Author(s) 2021 Open AccessThis 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/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Original Article Choovuthayakorn, Janejit Tantraworasin, Apichat Phinyo, Phichayut Patumanond, Jayanton Kunavisarut, Paradee Srisomboon, Titipol Winaikosol, Pawara Patikulsila, Direk Chaikitmongkol, Voraporn Watanachai, Nawat Pathanapitoon, Kessara Factors associated with 1-year visual response following intravitreal bevacizumab treatment for diabetic macular edema: a retrospective single center study |
title | Factors associated with 1-year visual response following intravitreal bevacizumab treatment for diabetic macular edema: a retrospective single center study |
title_full | Factors associated with 1-year visual response following intravitreal bevacizumab treatment for diabetic macular edema: a retrospective single center study |
title_fullStr | Factors associated with 1-year visual response following intravitreal bevacizumab treatment for diabetic macular edema: a retrospective single center study |
title_full_unstemmed | Factors associated with 1-year visual response following intravitreal bevacizumab treatment for diabetic macular edema: a retrospective single center study |
title_short | Factors associated with 1-year visual response following intravitreal bevacizumab treatment for diabetic macular edema: a retrospective single center study |
title_sort | factors associated with 1-year visual response following intravitreal bevacizumab treatment for diabetic macular edema: a retrospective single center study |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7931592/ https://www.ncbi.nlm.nih.gov/pubmed/33663604 http://dx.doi.org/10.1186/s40942-021-00286-9 |
work_keys_str_mv | AT choovuthayakornjanejit factorsassociatedwith1yearvisualresponsefollowingintravitrealbevacizumabtreatmentfordiabeticmacularedemaaretrospectivesinglecenterstudy AT tantraworasinapichat factorsassociatedwith1yearvisualresponsefollowingintravitrealbevacizumabtreatmentfordiabeticmacularedemaaretrospectivesinglecenterstudy AT phinyophichayut factorsassociatedwith1yearvisualresponsefollowingintravitrealbevacizumabtreatmentfordiabeticmacularedemaaretrospectivesinglecenterstudy AT patumanondjayanton factorsassociatedwith1yearvisualresponsefollowingintravitrealbevacizumabtreatmentfordiabeticmacularedemaaretrospectivesinglecenterstudy AT kunavisarutparadee factorsassociatedwith1yearvisualresponsefollowingintravitrealbevacizumabtreatmentfordiabeticmacularedemaaretrospectivesinglecenterstudy AT srisomboontitipol factorsassociatedwith1yearvisualresponsefollowingintravitrealbevacizumabtreatmentfordiabeticmacularedemaaretrospectivesinglecenterstudy AT winaikosolpawara factorsassociatedwith1yearvisualresponsefollowingintravitrealbevacizumabtreatmentfordiabeticmacularedemaaretrospectivesinglecenterstudy AT patikulsiladirek factorsassociatedwith1yearvisualresponsefollowingintravitrealbevacizumabtreatmentfordiabeticmacularedemaaretrospectivesinglecenterstudy AT chaikitmongkolvoraporn factorsassociatedwith1yearvisualresponsefollowingintravitrealbevacizumabtreatmentfordiabeticmacularedemaaretrospectivesinglecenterstudy AT watanachainawat factorsassociatedwith1yearvisualresponsefollowingintravitrealbevacizumabtreatmentfordiabeticmacularedemaaretrospectivesinglecenterstudy AT pathanapitoonkessara factorsassociatedwith1yearvisualresponsefollowingintravitrealbevacizumabtreatmentfordiabeticmacularedemaaretrospectivesinglecenterstudy |