Characteristics of diabetic macular edema patients refractory to anti-VEGF treatments and a dexamethasone implant.
<h4>Purpose</h4>To determine the characteristics of diabetic macular edema (DME) patients refractory to intravitreal bevacizumab (IVB) treatments and an additional dexamethasone implant.<h4>Methods</h4>We classified 119 DME patients according to whether or not they are respon...
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| Format: | Article |
| Language: | English |
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Public Library of Science (PLoS)
2019-01-01
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| Series: | PLoS ONE |
| Online Access: | https://doi.org/10.1371/journal.pone.0222364 |
| _version_ | 1819145957671960576 |
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| author | Moon Young Choi Donghyun Jee Jin-Woo Kwon |
| author_facet | Moon Young Choi Donghyun Jee Jin-Woo Kwon |
| author_sort | Moon Young Choi |
| collection | DOAJ |
| description | <h4>Purpose</h4>To determine the characteristics of diabetic macular edema (DME) patients refractory to intravitreal bevacizumab (IVB) treatments and an additional dexamethasone implant.<h4>Methods</h4>We classified 119 DME patients according to whether or not they are responsive to 3 consecutive monthly anti-VEGF treatments and/or an additional dexamethasone implant. We compared their concentrations of IL (interleukin)-1β, IL-8, IL-10, IL-17, placental growth factor (PlGF), and vascular endothelial growth factor (VEGF) in the aqueous humor as well as their optical coherence tomography (OCT) findings, and baseline characteristics. We used logistic regression analyses to identify preoperative factors related to refractoriness to treatments.<h4>Results</h4>Of 119 treatment-naïve DME patients, 50 (42.02%) patients showed responsiveness [central subfield thickness (CST) < 300μm] after 3 IVBs, and 59 (49.58%) patients showed responsiveness after an additional dexamethasone implant, but 10 (8.40%) patients showed CST 300 ≥ μm even after both treatments. Refractory DME patients showed significantly higher number of hyperreflective foci (HF) in the OCT and higher average level of aqueous IL-1β at baseline (p<0.001 and p = 0.042, respectively). In the logistic regression analysis, higher number of HF in the OCT was associated with the refractoriness to both treatments (odds ratio [OR]: 7.03, p = 0.007).<h4>Conclusions</h4>Higher number of HF in the OCT at the initial visit was associated with poor responses to IVBs and an additional dexamethasone implant. |
| first_indexed | 2024-12-22T13:06:17Z |
| format | Article |
| id | doaj.art-d7332d52c09d4c4aa51b5e2db5a430c7 |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-12-22T13:06:17Z |
| publishDate | 2019-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj.art-d7332d52c09d4c4aa51b5e2db5a430c72022-12-21T18:24:52ZengPublic Library of Science (PLoS)PLoS ONE1932-62032019-01-01149e022236410.1371/journal.pone.0222364Characteristics of diabetic macular edema patients refractory to anti-VEGF treatments and a dexamethasone implant.Moon Young ChoiDonghyun JeeJin-Woo Kwon<h4>Purpose</h4>To determine the characteristics of diabetic macular edema (DME) patients refractory to intravitreal bevacizumab (IVB) treatments and an additional dexamethasone implant.<h4>Methods</h4>We classified 119 DME patients according to whether or not they are responsive to 3 consecutive monthly anti-VEGF treatments and/or an additional dexamethasone implant. We compared their concentrations of IL (interleukin)-1β, IL-8, IL-10, IL-17, placental growth factor (PlGF), and vascular endothelial growth factor (VEGF) in the aqueous humor as well as their optical coherence tomography (OCT) findings, and baseline characteristics. We used logistic regression analyses to identify preoperative factors related to refractoriness to treatments.<h4>Results</h4>Of 119 treatment-naïve DME patients, 50 (42.02%) patients showed responsiveness [central subfield thickness (CST) < 300μm] after 3 IVBs, and 59 (49.58%) patients showed responsiveness after an additional dexamethasone implant, but 10 (8.40%) patients showed CST 300 ≥ μm even after both treatments. Refractory DME patients showed significantly higher number of hyperreflective foci (HF) in the OCT and higher average level of aqueous IL-1β at baseline (p<0.001 and p = 0.042, respectively). In the logistic regression analysis, higher number of HF in the OCT was associated with the refractoriness to both treatments (odds ratio [OR]: 7.03, p = 0.007).<h4>Conclusions</h4>Higher number of HF in the OCT at the initial visit was associated with poor responses to IVBs and an additional dexamethasone implant.https://doi.org/10.1371/journal.pone.0222364 |
| spellingShingle | Moon Young Choi Donghyun Jee Jin-Woo Kwon Characteristics of diabetic macular edema patients refractory to anti-VEGF treatments and a dexamethasone implant. PLoS ONE |
| title | Characteristics of diabetic macular edema patients refractory to anti-VEGF treatments and a dexamethasone implant. |
| title_full | Characteristics of diabetic macular edema patients refractory to anti-VEGF treatments and a dexamethasone implant. |
| title_fullStr | Characteristics of diabetic macular edema patients refractory to anti-VEGF treatments and a dexamethasone implant. |
| title_full_unstemmed | Characteristics of diabetic macular edema patients refractory to anti-VEGF treatments and a dexamethasone implant. |
| title_short | Characteristics of diabetic macular edema patients refractory to anti-VEGF treatments and a dexamethasone implant. |
| title_sort | characteristics of diabetic macular edema patients refractory to anti vegf treatments and a dexamethasone implant |
| url | https://doi.org/10.1371/journal.pone.0222364 |
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