Microvascular Changes After Conbercept Intravitreal Injection of PDR With or Without Center-Involved Diabetic Macular Edema Analyzed by OCTA

Lin, Wei; Feng, Ming; Liu, Tingting; Wang, Qingxu; Wang, Wenqi; Xie, Xiaobin; Li, Wenhao; Guan, Jitian; Ma, Zhong‐Qi; Liu, Tong; Zhou, Qingjun

doi:10.3389/fmed.2022.797087

Cited by 4 publications

(5 citation statements)

References 32 publications

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“…Quantitative indicators of FAZ and SCP in OCTA are related to the severity of DR (34)(35)(36). In this study, changes in the FAZ and SCP in the IVC+PRP group are consistent with previous research (37,38), indicating that IVC+PRP therapy has a positive effect on macular perfusion status. These results suggest that IVC+PRP therapy can prevent the progression of DR-related non-perfusion.…”

Section: Discussionsupporting

confidence: 89%

Retinal vein changes in patients with high-risk proliferative diabetic retinopathy treated with conbercept and panretinal photocoagulation co-therapy: a cohort study

Si,

Tao,

Zhang

et al. 2023

Front. Endocrinol.

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ObjectiveThis study aimed to observe and compare retinal vein diameter changes and other essential indicators in patients with high-risk proliferative diabetic retinopathy (PDR) treated with intravitreal injection of conbercept (IVC) combined with panretinal photocoagulation (PRP) versus PRP monotherapy.MethodsA retrospective analysis was conducted on data from patients with high-risk PDR who received specific treatment and were followed up for 24 months. Among 82 patients with high-risk PDR, 50 eyes received PRP combined with IVC, whereas 32 eyes received PRP alone. During the 24-month follow-up period, changes in best-corrected visual acuity (BCVA), central foveal thickness (CFT), retinal vein diameter, number of microaneurysms (MA), neovascularization (NV) area, hard exudate (HE) area, size of the foveal avascular zone (FAZ), superficial capillary plexus (SCP) blood flow density, and adverse effects were recorded and compared between the two groups at baseline and at 6, 12, 18, and 24 months after treatment. The relationship between each observation index and vein diameter was also analyzed.ResultsDuring the 24-month follow up, significant improvements in the BCVA, CFT, retinal vein diameter, number of MAs, NV area, HE area, FAZ, and SCP were observed in the IVC+PRP group after treatment. The PRP group only showed significant reductions in NV and HE areas. The IVC+PRP group showed significant superiority over the PRP group in improving the vein diameter, number of MA, and HE area. However, no statistically significant difference in NV area reduction was found between the groups.ConclusionIn the treatment of high-risk PDR, IVC+PRP therapy has a significant advantage over PRP monotherapy. IVC+PRP therapy may reverse diabetes-induced retinal vein changes, restoring morphology and function.

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Section: Discussionsupporting

confidence: 89%

Retinal vein changes in patients with high-risk proliferative diabetic retinopathy treated with conbercept and panretinal photocoagulation co-therapy: a cohort study

Si,

Tao,

Zhang

et al. 2023

Front. Endocrinol.

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“…most researchers laid focus on clinically signi cant macular edema (CSME) and DME at advanced and severe stages [6, 15,16,[18][19][20], this study unveiled the OCTA parameter feature and the associated risk factors at the beginning of DME formation.…”

Section: Discussionmentioning

confidence: 86%

“…Previous studies used these quantitative OCTA metrics to indicate the severity of DR and prognosticate the development of DME [6, [14][15][16][17][18]. Recent studies laid emphasis on OCTA metric changes in CSME patients post anti-VEGF treatment [19,20]. However, most researches studied advanced and severe DME, because DME cannot be reliably detected unless the retinal thickness is greater than 300 µm by OCT [21].…”

mentioning

confidence: 99%

Associated factors and macular vascular perfusion change for diabetic macular edema at early stage: a cross-sectional observational study

Shen

Cheng

et al. 2023

Preprint

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Background Associated factors and microvasculature change of clinically significant macular edema (CSME) were fully studied. This study was intended to investigate the associated factors and macular vascular perfusion change for diabetic macular edema (DME) at the early stage. Methods This study was a cross-sectional observational study. A total of 255 eyes of 128 diabetes mellitus patients were enrolled and underwent a serious of ophthalmological and systemic evaluation. Early DME was characterized by central subfoveal thickness (CST) value between 250µm and 325µm, detectable inner retinal layers, intact ellipsoid zone and external limiting membrane. While non-DME was characterized by CST <250µm with normal retinal morphology and structure. Results Treatment method, age, body mass index, diabetic duration, HbA1c level, total cholesterol, triglycerides, blood urea, blood pressure, proteinuria, serum creatinine and estimated glomerular filtration rate (eGFR) were not associated with early DME development. Male, HbA1c level ≤ 8% and cumulative insulin dosage ≥ 30000U were significantly associated with higher risk of early DME. Vessel density, microaneurysms number and hyperreflective foci number were not significantly different between non-DME and early DME patients. Foveal avascular zone (FAZ) area ≤ 0.3mm2 was significantly associated with higher risk of early DME. Correlation analysis results showed that FAZ area was not correlated with cumulative insulin dosage, age, or diabetes duration. Conclusions Higher cumulative insulin dosage, lower HbA1c level and male could be risk factors for early DME development. Compared to non-DME, early DME showed a significant FAZ area reduction. Our results highlighted the important role of insulin in early DME development, indicated an early worsen of DME with tight blood glucose control and suggested an intervention of insulin-related retinal impairment.

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“…Clinically, DME is defined as a retinal thickening or hard exudation within 1.5 mm of the fovea. The mechanism of DME may involve a local inflammatory reaction or oxidative stress reaction[ 13 ]. It damages the retinal barrier and increases retinal permeability.…”

Section: Discussionmentioning

confidence: 99%

Conbercept combined with laser photocoagulation in the treatment of diabetic macular edema and its influence on intraocular cytokines

Zhan¹,

Zhou²,

Zhang³

et al. 2023

World J Diabetes

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The incidence of type 2 diabetes mellitus is growing in epidemic proportions and has become one of the most critical public health concerns. Cardiovascular complications associated with diabetes are the leading cause of morbidity and mortality. The cardiovascular diseases that accompany diabetes include angina, myocardial infarction, stroke, peripheral artery disease, and congestive heart failure. Among the various risk factors generated secondary to hyperglycemic situations, advanced glycation end products (AGEs) are one of the important targets for future diagnosis and prevention of diabetes. In the last decade, AGEs have drawn a lot of attention due to their involvement in diabetic patho-physiology. AGEs can be derived exogenously and endogenously through various pathways. These are a nonhomogeneous, chemically diverse group of compounds formed nonenzymatically by condensation between carbonyl groups of reducing sugars and free amino groups of protein, lipids, and nucleic acid. AGEs mediate their pathological effects at the cellular and extracellular levels by multiple pathways. At the cellular level, they activate signaling cascades via the receptor for AGEs and initiate a complex series of intracellular signaling resulting in reactive oxygen species generation, inflammation, cellular proliferation, and fibrosis that may possibly exacerbate the damaging effects on cardiac functions in diabetics. AGEs also cause covalent modifications and cross-linking of serum and extracellular matrix proteins; altering their structure, stability, and functions. Early diagnosis of diabetes may prevent its progression to complications and decrease its associated comorbidities. In the present review, we recapitulate the role of AGEs as a crucial mediator of hyperglycemia-mediated detrimental effects in diabetes-associated complications. Furthermore, this review presents an overview of future perspectives for new therapeutic interventions to ameliorate cardiovascular complications in diabetes.

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Microvascular Changes After Conbercept Intravitreal Injection of PDR With or Without Center-Involved Diabetic Macular Edema Analyzed by OCTA

Cited by 4 publications

References 32 publications

Retinal vein changes in patients with high-risk proliferative diabetic retinopathy treated with conbercept and panretinal photocoagulation co-therapy: a cohort study

Retinal vein changes in patients with high-risk proliferative diabetic retinopathy treated with conbercept and panretinal photocoagulation co-therapy: a cohort study

Associated factors and macular vascular perfusion change for diabetic macular edema at early stage: a cross-sectional observational study

Conbercept combined with laser photocoagulation in the treatment of diabetic macular edema and its influence on intraocular cytokines

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