Proteinuria as a Potential Biomarker for the Efficacy of Intravitreal Bevacizumab Injection in Patients with Diabetic Macular Edema

Abstract

Purpose: Anti-vascular endothelial growth factor (anti-VEGF) agents are good therapeutic options for diabetic macular edema (DME), especially in patients with DME that is refractory or shows delayed response to anti-VEGF treatment. We investigated the change of proteinuria following intravitreal bevacizumab injection (IVB) as a potential biomarker for treatment-responsiveness in patients with DME. Methods: This pilot study was performed as secondary analysis of patients with diabetic retinopathy (DR) from prospectively enrolled patients scheduled for IVB from May 2018 to December 2018. Fifty-three patients with DR (30 with DME and 23 without DME) were initially included, and 46 eyes were finally included for analysis after propensity score matching. Urine tests were performed within 1 month before and 7 ± 1 days after IVB. The concentrations of urine protein and albumin were quantitatively measured, and the urinary albumin-to-creatinine ratio (UACR) was calculated from data before and after IVB. Results: There were no significant differences in mean concentrations of urine albumin and protein between patients with and without DME. More patients in the DME group showed abnormal level of albuminuria both before and after IVB, but these differences were not statistically significant between the groups. A correlation analysis revealed no significant association between change in UACR and that of central retinal thickness. Conclusion: Change in proteinuria was not a proper biomarker of the response to IVB in patients with DME.

Clinical Application of Intravitreal Aflibercept Injection for Diabetic Macular Edema Comparing Two Loading Regimens

“…Diabetic macular edema (DME) is one of the main causes of chronic visual impairment and vision loss in the working adult population with diabetic retinopathy (DR) [ 1 ]. The prevalence of diabetes mellitus (DM) is increasing worldwide, leading to an increase in the incidence of DR and DME.…”