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Evaluation of microaneurysms as predictors of therapeutic response to anti-VEGF therapy in patients with DME

Administration of intravitreal anti-vascular endothelial growth factor (anti-VEGF) therapy is the first-line therapy for diabetic macular oedema (DME). However, some patients show no or insufficient response to repeated anti-VEGF injections. Therefore, it is necessary to identify factors that can pr...

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Autores principales: Hatano, Makoto, Higashijima, Fumiaki, Yoshimoto, Takuya, Ogata, Tadahiko, Ohta, Manami, Kobayashi, Yuka, Wakuta, Makiko, Yanai, Ryoji, Kimura, Kazuhiro
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9704562/
https://www.ncbi.nlm.nih.gov/pubmed/36441722
http://dx.doi.org/10.1371/journal.pone.0277920
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author Hatano, Makoto
Higashijima, Fumiaki
Yoshimoto, Takuya
Ogata, Tadahiko
Ohta, Manami
Kobayashi, Yuka
Wakuta, Makiko
Yanai, Ryoji
Kimura, Kazuhiro
author_facet Hatano, Makoto
Higashijima, Fumiaki
Yoshimoto, Takuya
Ogata, Tadahiko
Ohta, Manami
Kobayashi, Yuka
Wakuta, Makiko
Yanai, Ryoji
Kimura, Kazuhiro
author_sort Hatano, Makoto
collection PubMed
description Administration of intravitreal anti-vascular endothelial growth factor (anti-VEGF) therapy is the first-line therapy for diabetic macular oedema (DME). However, some patients show no or insufficient response to repeated anti-VEGF injections. Therefore, it is necessary to identify factors that can predict this resistance against anti-VEGF treatment. Presence of microaneurysms (MAs) is a predictor of the development and progression of DME, but its relationship with the treatment response to the anti-VEGF agents is not well known. Therefore, we aimed to elucidate the relationship between the distribution of MAs and the response to anti-VEGF therapy in patients with DME. The number of MAs was measured before anti-VEGF therapy in each region using fluorescein angiography, indocyanine green angiography (IA), and optical coherence tomography angiography. Patients with DME were divided into the responder and non-responder groups after three loading phases. Differences in the distribution of MAs between the groups were investigated. Pre-treatment IA revealed more MAs in the nasal area in the non-responder group than in the responder group (10.7 ± 10.7 and 5.7 ± 5.7, respectively, in the nasal macula) (1.4 ± 2.1 and 0.4 ± 0.7, respectively, in the nasal fovea). Whereas, pre-treatment FA and OCTA could not reveal significantly difference between the groups. Detection of MAs in the nasal macula using pre-treatment IA may indicate resistance to anti-VEGF therapy. We recommend the clinicians confirm the presence of MAs in the nasal macula, as shown by IA, as a predictor of therapeutic response to anti-VEGF therapy in patients with treatment naive DME.
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spelling pubmed-97045622022-11-29 Evaluation of microaneurysms as predictors of therapeutic response to anti-VEGF therapy in patients with DME Hatano, Makoto Higashijima, Fumiaki Yoshimoto, Takuya Ogata, Tadahiko Ohta, Manami Kobayashi, Yuka Wakuta, Makiko Yanai, Ryoji Kimura, Kazuhiro PLoS One Research Article Administration of intravitreal anti-vascular endothelial growth factor (anti-VEGF) therapy is the first-line therapy for diabetic macular oedema (DME). However, some patients show no or insufficient response to repeated anti-VEGF injections. Therefore, it is necessary to identify factors that can predict this resistance against anti-VEGF treatment. Presence of microaneurysms (MAs) is a predictor of the development and progression of DME, but its relationship with the treatment response to the anti-VEGF agents is not well known. Therefore, we aimed to elucidate the relationship between the distribution of MAs and the response to anti-VEGF therapy in patients with DME. The number of MAs was measured before anti-VEGF therapy in each region using fluorescein angiography, indocyanine green angiography (IA), and optical coherence tomography angiography. Patients with DME were divided into the responder and non-responder groups after three loading phases. Differences in the distribution of MAs between the groups were investigated. Pre-treatment IA revealed more MAs in the nasal area in the non-responder group than in the responder group (10.7 ± 10.7 and 5.7 ± 5.7, respectively, in the nasal macula) (1.4 ± 2.1 and 0.4 ± 0.7, respectively, in the nasal fovea). Whereas, pre-treatment FA and OCTA could not reveal significantly difference between the groups. Detection of MAs in the nasal macula using pre-treatment IA may indicate resistance to anti-VEGF therapy. We recommend the clinicians confirm the presence of MAs in the nasal macula, as shown by IA, as a predictor of therapeutic response to anti-VEGF therapy in patients with treatment naive DME. Public Library of Science 2022-11-28 /pmc/articles/PMC9704562/ /pubmed/36441722 http://dx.doi.org/10.1371/journal.pone.0277920 Text en © 2022 Hatano et al https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Hatano, Makoto
Higashijima, Fumiaki
Yoshimoto, Takuya
Ogata, Tadahiko
Ohta, Manami
Kobayashi, Yuka
Wakuta, Makiko
Yanai, Ryoji
Kimura, Kazuhiro
Evaluation of microaneurysms as predictors of therapeutic response to anti-VEGF therapy in patients with DME
title Evaluation of microaneurysms as predictors of therapeutic response to anti-VEGF therapy in patients with DME
title_full Evaluation of microaneurysms as predictors of therapeutic response to anti-VEGF therapy in patients with DME
title_fullStr Evaluation of microaneurysms as predictors of therapeutic response to anti-VEGF therapy in patients with DME
title_full_unstemmed Evaluation of microaneurysms as predictors of therapeutic response to anti-VEGF therapy in patients with DME
title_short Evaluation of microaneurysms as predictors of therapeutic response to anti-VEGF therapy in patients with DME
title_sort evaluation of microaneurysms as predictors of therapeutic response to anti-vegf therapy in patients with dme
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9704562/
https://www.ncbi.nlm.nih.gov/pubmed/36441722
http://dx.doi.org/10.1371/journal.pone.0277920
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