Reoperation successfully achieved hole closure and ultimate visual improvement in most eyes with recurrent macular holes. Most patients with recurrent holes previously had, or later developed, full-thickness macular holes in the other eye.
Purpose
With multiple anti-vascular endothelial growth factor and steroid
therapies available for diabetic macular edema (DME), there is a need for
early determination of the best treatment for a particular patient to
prevent irreversible vision loss from chronic DME. In this study, we
classify patients as responders or non-responders to anti-vascular
endothelial growth factor (VEGF) monotherapy in the treatment of DME after a
single anti-VEGF injection.
Methods
The study was designed as a single center, retrospective,
interventional case series. We included patients who received 3 consecutive
monthly injections with the same anti-VEGF agent. We excluded patients who
were treated for DME in the preceding 3 months with any form of anti-VEGF
therapy. Visual acuity and central retinal thickness (CRT) data were
followed for one year. Receiver operating characteristic (ROC) curve
analysis was performed in order to identify cutoff values for identifying
responders.
Results
107 eyes were reviewed, with 40 eyes of 34 patients meeting all
inclusion criteria. Based on ROC curve analysis, a reduction in CRT by
> 15% at 1-month, identified eyes that responded to
treatment and had a >25% reduction in CRT at 3-months
(sensitivity 0.75, specificity 0.92).
Conclusion
DME eyes that have early response to anti-VEGF treatment by reduction
in CRT will have significant response to treatment by 3 months.
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