Flavoprotein Fluorescence Correlation with Visual Acuity Response in Patients Receiving Anti-VEGF Injection for Diabetic Macular Edema

Romo, Jorge S Andrade; Lynch, Giselle; Liu, Kevin; Kim, Daniel; Jansen, Michael; Field, Matthew G.; Elner, Victor M.; Rosen, Richard B.

doi:10.1155/2018/3567306

Cited by 12 publications

(7 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…10,18 Previous studies have demonstrated the utility of FPF in detecting retinal metabolic stress in diabetic retinopathy, 12 with correlations found between FPF and visual acuity responses in patients undergoing treatment for diabetic macula edema independent of OCT findings. 19 The patients with age-related macular degeneration, central serous chorioretinopathy retinal dystrophies, ocular hypertension, and primary open angle glaucoma have also been found to have the higher retinal FPF scores indicative of mitochondrial dysfunction in various observational studies. 11,13,20,21 More recently, FPF measurements have been obtained from the optic disc rim and found to be increased in POAG patients compared with controls, 14 although advances in software computational algorithms for FPF mean that our scores were not directly comparable with prior studies.…”

Section: Discussionmentioning

confidence: 99%

“…With mitochondrial dysfunction now understood to play a critical role in glaucomatous optic neuropathy, FPF has emerged as a potential novel biomarker among noninvasive options being developed 10,18. Previous studies have demonstrated the utility of FPF in detecting retinal metabolic stress in diabetic retinopathy,12 with correlations found between FPF and visual acuity responses in patients undergoing treatment for diabetic macula edema independent of OCT findings 19. The patients with age-related macular degeneration, central serous chorioretinopathy retinal dystrophies, ocular hypertension, and primary open angle glaucoma have also been found to have the higher retinal FPF scores indicative of mitochondrial dysfunction in various observational studies 11,13,20,21.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Structural and Metabolic Imaging After Short-term Use of the Balance Goggles System in Glaucoma Patients: A Pilot Study

Sun

Beykin

Lee

et al. 2022

Journal of Glaucoma

View full text Add to dashboard Cite

Short-term use of the Balance Goggles System (BGS) in glaucoma patients was not associated with the observable changes in conventional ocular coherence tomography (OCT) imaging, but metabolic imaging using peripapillary flavoprotein fluorescence (FPF) may represent a useful adjuctive investigation.Objective: To determine whether the intraocular pressure (IOP)lowering effects of the BGS are accompanied by changes in retinal thickness measured by OCT, retinal vascular density measured by ocular coherence tomography-angiography (OCTA), or novel peripapillary metabolic profiling using FPF measured by a fundus camera.Design: Prospective comparative case-series.Subjects: Eight eyes from 8 patients with open angle glaucoma ranging from mild to severe. Methods:In this prospective, single-center, open-label, nonrandomized, and single-arm study patients received a baseline evaluation including retinal imaging, then 1 hour of negative pressure application through the BGS, followed by repeat retinal imaging. Participants then used the BGS at home for 1 month and underwent a repeat evaluation at the conclusion of the trial.Main Outcome Measures: Changes in nerve fiber layer thickness, OCTA vascular parameters, and FPF scores.Results: Mean baseline IOP was 18.0 ± 3.1 mmHg and there was no significant change in IOP at follow-up. At 1 month compared with baseline, there was a statistically significant improvement in FPF optic nerve head rim scores (12.7 ± 11.6 to 10.5 ± 7.5; P = 0.04). In addition, there was a trend toward an increase in retinal nerve fiber layer thickness after 1 month (69.5 ± 14.2 to 72.0 ± 13.7; P = 0.1), but there were no statistically significant differences observable with any of the OCTA vascular parameters either at 1 hour or after 1 month.Conclusions: There were no significant changes observable using conventional OCT imaging after short-term use of the BGS, although metabolic imaging using FPF may be a useful potential biomarker to complement existing investigations. Additional studies are warranted to further investigate these changes.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Structural and Metabolic Imaging After Short-term Use of the Balance Goggles System in Glaucoma Patients: A Pilot Study

Sun

Beykin

Lee

et al. 2022

Journal of Glaucoma

View full text Add to dashboard Cite

show abstract

“…Significant FPF elevation is detected in nAMD patients [242]. Discovery of FPF led to a quantifying technique for FPF emission from a patient's retina, developing imaging tests based on metabolic indicator for predicting disease progression in the retina [243][244][245][246].…”

Section: Metabolic Activity In Namd and Neurodegenerationmentioning

confidence: 99%

Construction of an Exudative Age-Related Macular Degeneration Diagnostic and Therapeutic Molecular Network Using Multi-Layer Network Analysis, a Fuzzy Logic Model, and Deep Learning Techniques: Are Retinal and Brain Neurodegenerative Disorders Related?

Latifi-Navid,

Barzegar Behrooz,

Jamehdor

et al. 2023

Pharmaceuticals

View full text Add to dashboard Cite

Neovascular age-related macular degeneration (nAMD) is a leading cause of irreversible visual impairment in the elderly. The current management of nAMD is limited and involves regular intravitreal administration of anti-vascular endothelial growth factor (anti-VEGF). However, the effectiveness of these treatments is limited by overlapping and compensatory pathways leading to unresponsiveness to anti-VEGF treatments in a significant portion of nAMD patients. Therefore, a system view of pathways involved in pathophysiology of nAMD will have significant clinical value. The aim of this study was to identify proteins, miRNAs, long non-coding RNAs (lncRNAs), various metabolites, and single-nucleotide polymorphisms (SNPs) with a significant role in the pathogenesis of nAMD. To accomplish this goal, we conducted a multi-layer network analysis, which identified 30 key genes, six miRNAs, and four lncRNAs. We also found three key metabolites that are common with AMD, Alzheimer’s disease (AD) and schizophrenia. Moreover, we identified nine key SNPs and their related genes that are common among AMD, AD, schizophrenia, multiple sclerosis (MS), and Parkinson’s disease (PD). Thus, our findings suggest that there exists a connection between nAMD and the aforementioned neurodegenerative disorders. In addition, our study also demonstrates the effectiveness of using artificial intelligence, specifically the LSTM network, a fuzzy logic model, and genetic algorithms, to identify important metabolites in complex metabolic pathways to open new avenues for the design and/or repurposing of drugs for nAMD treatment.

show abstract

“…[242][243][244][245] Newer fundus imaging techniques, such as flavoprotein fluorescence (FPF) may allow the detection of metabolic improvements that precede structural improvements in DME patients receiving anti-VEGF injections. 246 Functional testing of macular sensitivity utilizing microperimetry and electroretinography is also being increasingly used in both DR and DME to assess both disease severity and response to therapy. [247][248][249][250][251][252][253][254][255][256][257][258][259][260][261][262] These provide new indices to explore, seeking prognostic value for response to therapy.…”

Section: Future Trends Diagnosticsmentioning

confidence: 99%

<p>The Evolving Treatment of Diabetic Retinopathy</p>

Mansour¹,

Browning²,

Wong³

et al. 2020

OPTH

151

119

View full text Add to dashboard Cite

Purpose: To review the current therapeutic options for the management of diabetic retinopathy (DR) and diabetic macular edema (DME) and examine the evidence for integration of laser and pharmacotherapy. Methods: A review of the PubMed database was performed using the search terms diabetic retinopathy, diabetic macular edema, neovascularization, laser photocoagulation, intravitreal injection, vascular endothelial growth factor (VEGF), vitrectomy, pars plana vitreous surgery, antiangiogenic therapy. With additional cross-referencing, this yielded 835 publications of which 301 were selected based on content and relevance. Results: Many recent studies have evaluated the pharmacological, laser and surgical therapeutic strategies for the treatment and prevention of DR and DME. Several newer diagnostic systems such as optical coherence tomography (OCT), microperimetry, and multifocal electroretinography (mfERG) are also assisting in further refinements in the staging and classification of DR and DME. Pharmacological therapies for both DR and DME include both systemic and ocular agents. Systemic agents that promote intensive glycemic control, control of dyslipidemia and antagonists of the renin-angiotensin system demonstrate beneficial effects for both DR and DME. Ocular therapies include anti-VEGF agents, corticosteroids and nonsteroidal anti-inflammatory drugs. Laser therapy, both as panretinal and focal or grid applications continue to be employed in management of DR and DME. Refinements in laser devices have yielded more tissue-sparing (subthreshold) modes in which many of the benefits of conventional continuous wave (CW) lasers can be obtained without the adverse side effects. Recent attempts to lessen the burden of anti-VEGF injections by integrating laser therapy have met with mixed results. Increasingly, vitreoretinal surgical techniques are employed for less advanced stages of DR and DME. The development and use of smaller gauge instrumentation and advanced anesthesia agents have been associated with a trend toward earlier surgical intervention for diabetic retinopathy. Several novel drug delivery strategies are currently being examined with the goal of decreasing the therapeutic burden of monthly intravitreal injections. These fall into one of the five categories: non-biodegradable polymeric drug delivery systems, biodegradable polymeric drug delivery systems, nanoparticle-based drug delivery systems, ocular injection devices and with sustained release refillable devices. At present, there remains no one single strategy for the management of the particular stages of DR and DME as there are many options that have not been rigorously tested through large, randomized, controlled clinical trials. Conclusion: Pharmacotherapy, both ocular and systemic, will be the primary mode of intervention in the management of DR and DME in many cases when cost and treatment burden are less constrained. Conventional laser therapy has become a secondary intervention in these instances, but remains a first-line option when cost and ...

show abstract

Flavoprotein Fluorescence Correlation with Visual Acuity Response in Patients Receiving Anti-VEGF Injection for Diabetic Macular Edema

Cited by 12 publications

References 27 publications

Structural and Metabolic Imaging After Short-term Use of the Balance Goggles System in Glaucoma Patients: A Pilot Study

Structural and Metabolic Imaging After Short-term Use of the Balance Goggles System in Glaucoma Patients: A Pilot Study

Construction of an Exudative Age-Related Macular Degeneration Diagnostic and Therapeutic Molecular Network Using Multi-Layer Network Analysis, a Fuzzy Logic Model, and Deep Learning Techniques: Are Retinal and Brain Neurodegenerative Disorders Related?

<p>The Evolving Treatment of Diabetic Retinopathy</p>

Contact Info

Product

Resources

About