Relationship between Diabetic Nephropathy and Development of Diabetic Macular Edema in Addition to Diabetic Retinopathy

Suzuki, Yukihisa; Kiyosawa, Motohiro

doi:10.3390/biomedicines11051502

Cited by 10 publications

(5 citation statements)

References 84 publications

(101 reference statements)

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“…However, as the anti-VEGF drug is metabolized in the eye, macular edema reappears when the intraocular concentration of the anti-VEGF drug is lower than the therapeutic concentration, so the anti-VEGF drug needs to be injected repeatedly. The anti-VEGF drug, 3 + PRN is widely recognized and used in clinical practice and its effectiveness and safety have been confirmed by several previous studies [14,15]. With the deepening of clinical research, the latest view is that early intensification of anti-VEGF drugs is more effective for edema resolution and visual protection.…”

Section: Discussionmentioning

confidence: 88%

Study on the efficacy of different injection regimens of aflibercept in the treatment of diabetic macular edema

Liu,

Wang,

Peng

et al. 2024

Trop. J. Pharm Res

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Purpose: To determine the efficacy of different regimens of aflibercept injection in the treatment of diabetic macular edema (DME). Methods: A retrospective analysis was performed on 78 DME patients admitted to Affiliated Hospital of Hebei University, China from January 2021 to December 2022. The patients, categorized into control group (39 patients) and study group (39 patients), received varying regimens of aflibercept injections pro re nata (PRN); 3 + PRN regimen and 5 + PRN regimen, respectively. Best-corrected visual acuity (BCVA) and central macular thickness (CMT) were measured at baseline, 1, 3, 6, and 12 months following treatment. The proportions of BCVA improvement by 10 and 15 letters at 12 months and incidence of visual acuity instability during the as-needed period were calculated. Adverse events were also recorded. Results: The BCVA significantly improved in both groups at 3, 6, and 12 months (p < 0.05), with no significant difference between the groups (p > 0.05). The proportions of BCVA improvement by 10 and 15 letters at 12 months were similar between the groups. Study group had a significantly lower rate of visual acuity instability during the as- needed period (p < 0.05) compared to control group. The CMT significantly reduced in both groups at all time points (p < 0.05), with no significant difference observed between the groups. Study group had significantly fewer injections during the as-needed period (p < 0.05) compared to control group. Adverse events did not significantly differ between the two groups. Conclusion: Both 3 + PRN and 5 + PRN regimens of Aflibercept injection are effective in treating DME. However, the 5 + PRN regimen demonstrates a lower rate of visual acuity instability and requires fewer injections during the as-needed period. Future studies are needed to analyze the efficacy and differences between various injection regimens for treating DME.

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Section: Discussionmentioning

confidence: 88%

Study on the efficacy of different injection regimens of aflibercept in the treatment of diabetic macular edema

Liu,

Wang,

Peng

et al. 2024

Trop. J. Pharm Res

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“…Beyond the influence of the course and severity of diabetes on DME, the systemic influence caused by DN and its promoting effect on DME should also be considered. Previous studies reported that albuminuria, eGFR and DN grade were correlated with DME [9][10][11][12] . In addition, without specific eye treatment for DME, hemodialysis could significantly decrease the central retinal thickness and increase the BCVA [13][14] .…”

Section: Discussionmentioning

confidence: 92%

Intravitreal injection of conbercept for diabetic macular edema complicated with diabetic nephropathy

Zhu,

Wang,

et al. 2024

Int J Ophthalmol

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AIM: To observe the therapeutic effect of conbercept on diabetic macular edema (DME) complicated with diabetic nephropathy (DN). METHODS: In this retrospective study, 54 patients (54 eyes) that diagnosed as DME from January 2017 to October 2021 were collected. The patients were divided into two groups: DME patients with DN (25 eyes), and DME patients without DN (29 eyes). General conditions were collected before treatment, laboratory tests include fasting blood glucose, HbA1c, microalbumin/creatinine, serum creatinine. Optical coherence tomography (OCT) was used to check the ellipsoidal zone (EZ) and external limiting membrane (ELM) integrity. Central macular thickness (CMT), best corrected visual acuity (BCVA), and retinal hyperreflective foci (HF) as well as numbers of injections were recorded. RESULTS: There were significant differences between fasting blood glucose, HbA1c, serum creatinine, urinary microalbumin/creatinine, and estimated glomerular filtration rate (eGFR) between the two groups (all P<0.05). EZ and ELM continuity in the DME+DN group was worse than that in the DME group (P<0.05). BCVA (logMAR) in the DME group was significantly better than that in the DME+DN group at the same time points during treatment (all P<0.05). CMT and HF values were significantly higher in the DME+DN group than that in the DME group at the all time points (all P<0.05) and significantly decreased in both groups with time during treatment. At 6mo after treatment, the mean number of injections in the DME+DN and DME group was 4.84±0.94 and 3.79±0.86, respectively. CONCLUSION: Conbercept has a significant effect in short-term treatment of DME patients with or without DN, and can significantly ameliorate BCVA, CMT and the number of HF, treatment efficacy of DME patients without DN is better than that of DME patients with DN.

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“…Although epidemiological research has shown that the incidence of DME in diabetes patients is approximately 5.5% [22] , that in DR patients reaches 21.1% [23] , and that in patients with proliferative DR (PDR) is as high as 66.2% [24] . Since the severity of DN is positively correlated with the severity of DME and DR [25] , theoretically, the incidence of DME is greater in patients with DN and PDR.…”

Section: Discussionmentioning

confidence: 99%

The effect of long-term hemodialysis on diabetic retinopathy observed by swept-source optical coherence tomography angiography

He,

Liu,

Shi

et al. 2024

Preprint

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Background Diabetes can cause chronic microvascular complications such as diabetic retinopathy (DR) and diabetic nephropathy (DN). DR and DN can lead to or exacerbate diabetic macular edema (DME). Hemodialysis (HD) is the main treatment method for patients with end-stage kidney disease (ESKD) secondary to DN. Purpose The aim of this prospective cohort study was to determine the changes in retinal and choroidal thickness in patients with ESKD before and after HD and the impact of long-term HD on DR. Methods Eighty-five eyes of 44 DR patients with ESKD who underwent HD were examined by swept-source optical coherence tomography angiography (SS-OCTA). Based on OCTA images, the characteristics of DR and the prevalence of DME in these patients were analyzed. Changes in central retinal thickness (CRT), central retinal volume (CRV), subfoveal choroidal thickness (SFCT) and subfoveal choroidal volume (SFCV) within 30 minutes before and after HD were compared. CRT, CRV, SFCT and SFCV were compared before HD and before the next HD. Results There was no significant difference in the average CRT (251.69 ± 39.21 µm vs. 251.46 ± 39.38 µm, P = 0.286) or CRV (0.15 ± 0.62 µm vs. 0.15 ± 0.63 µm, P = 0.324) between before and after HD. After HD, SFCT (243.11 ± 77.15 µm vs. 219.20 ± 72.84 µm, P < 0.001) and SFCV (0.15 ± 0.10 µm vs. 0.13 ± 0.90 µm, P < 0.001). significantly decreased. There was no statistically significant difference in CRT (251.69 ± 39.21 µm vs. 251.11 ± 38.47 µm, P = 0.206), CRV (0.15 ± 0.62 µm vs. 0.15 ± 0.61 µm, P = 0.154), SFCT (243.11 ± 77.15 µm vs. 245.41 ± 76.23 µm, P = 0.108), or SFCV (0.15 ± 0.10 µm vs. 0.16 ± 0.10 µm, P = 0.174) before HD and before the next HD. On en face OCTA images, eighty-five eyes (100%) had retinal nonperfusion areas, focal avascular zone (FAZ) enlargement, and abnormal retinal microvasculature. Based on cross-sectional OCTA images, retinal neovascularization (RNV) was confirmed in 42 eyes (49.41%), and intraretinal microvascular abnormalities (IRMAs) were detected in 85 eyes (100%). Seventeen eyes (20%) still had DME, and all had cystoid macular edema (CME). Among eyes with DME, the epiretinal membrane (ERM) was present in 7 eyes (8.24%). Conclusions For DR patients with ESKD who have undergone long-term HD, the choroidal thickness still changes significantly before and after HD, which may be related to short-term effects such as reduced blood volume and plasma osmotic pressure caused by HD. Although HD can improve DME, the DR of patients with ESKD should still be given attention.

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Relationship between Diabetic Nephropathy and Development of Diabetic Macular Edema in Addition to Diabetic Retinopathy

Cited by 10 publications

References 84 publications

Study on the efficacy of different injection regimens of aflibercept in the treatment of diabetic macular edema

Study on the efficacy of different injection regimens of aflibercept in the treatment of diabetic macular edema

Intravitreal injection of conbercept for diabetic macular edema complicated with diabetic nephropathy

The effect of long-term hemodialysis on diabetic retinopathy observed by swept-source optical coherence tomography angiography

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