Angiographic biomarkers are significant predictors of treatment response to intravitreal aflibercept in diabetic macular edema
Abstract 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 pati...
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| Format: | Article |
| Language: | English |
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Nature Portfolio
2023-05-01
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| Series: | Scientific Reports |
| Online Access: | https://doi.org/10.1038/s41598-023-35286-2 |
| _version_ | 1827943454672420864 |
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| author | Martin Hein Aleksandar Vukmirovic Ian J. Constable Vignesh Raja Arman Athwal K. Bailey Freund Chandrakumar Balaratnasingam |
| author_facet | Martin Hein Aleksandar Vukmirovic Ian J. Constable Vignesh Raja Arman Athwal K. Bailey Freund Chandrakumar Balaratnasingam |
| author_sort | Martin Hein |
| collection | DOAJ |
| description | Abstract 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. |
| first_indexed | 2024-03-13T10:15:47Z |
| format | Article |
| id | doaj.art-71f44476729343589720d0631ab02c3a |
| institution | Directory Open Access Journal |
| issn | 2045-2322 |
| language | English |
| last_indexed | 2024-03-13T10:15:47Z |
| publishDate | 2023-05-01 |
| publisher | Nature Portfolio |
| record_format | Article |
| series | Scientific Reports |
| spelling | doaj.art-71f44476729343589720d0631ab02c3a2023-05-21T11:15:25ZengNature PortfolioScientific Reports2045-23222023-05-0113111510.1038/s41598-023-35286-2Angiographic biomarkers are significant predictors of treatment response to intravitreal aflibercept in diabetic macular edemaMartin Hein0Aleksandar Vukmirovic1Ian J. Constable2Vignesh Raja3Arman Athwal4K. Bailey Freund5Chandrakumar Balaratnasingam6Lions Eye InstituteLions Eye InstituteLions Eye InstituteDepartment of Ophthalmology, Sir Charles Gairdner HospitalSchool of Engineering Science, Simon Fraser UniversityVitreous Retina Macula Consultants of New YorkLions Eye InstituteAbstract 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.https://doi.org/10.1038/s41598-023-35286-2 |
| spellingShingle | Martin Hein Aleksandar Vukmirovic Ian J. Constable Vignesh Raja Arman Athwal K. Bailey Freund Chandrakumar Balaratnasingam Angiographic biomarkers are significant predictors of treatment response to intravitreal aflibercept in diabetic macular edema Scientific Reports |
| 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 |
| url | https://doi.org/10.1038/s41598-023-35286-2 |
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