Visual Outcomes Based on Early Response to Anti-Vascular Endothelial Growth Factor Treatment for Diabetic Macular Edema

Abstract

Objective: To examine the relationship between early response to anti-vascular endothelial growth factor (VEGF) treatment and visual prognosis. Methods: We retrospectively separated 20 patients with persistent diabetic macular edema (DME) into two responder status groups based on the reduction of central macular thickness (CMT) from baseline to month 3: a delayed responder group (DRG) (≤25% CMT reduction, n = 11) and an immediate responder group (IRG) (>25% CMT reduction, n = 14). We also separated the patients into two responder status groups based on the logarithm of the minimum angle of resolution (logMAR) best-corrected visual acuity (BCVA): a visual nonimprovement group (VNIG) (≥0 logMAR BCVA improvement, n = 11) and a vi sual improvement group (VIG) (<0 logMAR BCVA improvement, n = 14). Finally, we assessed the correlations between logMAR BCVA changes from baseline to month 3 (ΔBCVA_M3) and those from baseline to month 12 (ΔBCVA_M12). Results: At month 12, BCVA was significantly more improved in the VIG than the VNIG (p < 0.005), but was not significantly different between the DRG and the IRG (p = 0.75). The Pearson correlation coefficient showed a significant relationship between ΔBCVA_M3 and ΔBCVA_M12 (r = 0.60, p < 0.005). Conclusions: BCVA showed significantly greater improvement in the VIG than in the VNIG. ΔBCVA_M3 may predict the visual outcome at month 12 in DME patients treated with anti-VEGF drugs.

Factors influencing clinical outcomes in patients with diabetic macular edema treated with intravitreal ranibizumab: comparison between responder and non-responder cases

“…Previous studies have defined the treatment response according to anatomical 15,28–30 or visual outcomes 29,30 . The definition of visual response was similar across studies (BCVA gain more than one line or LogMAR change <0).…”

Remodeling of Retinal Architecture in Diabetic Retinopathy: Disruption of Ocular Physiology and Visual Functions by Inflammatory Gene Products and Pyroptosis

“…Management of DR starts with screening patients for the signs of retinopathy and then treating them if vision-threatening lesions are identified. Typically, DME is treated with intravitreal administration of anti-VEGF based biologics or small organic molecules such as steroids ( Hodzic-Hadzibegovic et al, 2017 ; Koyanagi et al, 2018 ). Anti-VEGF agents have primarily replaced focal or grid laser photocoagulation of the macula as the first-line treatment of DME, although this remains an important adjunct therapy in refractory cases.…”

Visual and anatomic outcomes of sustained single agent anti-VEGF treatment versus double anti-VEGF switching in the treatment of persistent diabetic macular edema

“…Using the anatomical response-based classification, both groups had comparable visual improvement at month 12 (p = 0.75), with a statistically significant reduction in CRT in the immediate responder group (p = 0.01). However, using a visual response-based classification demonstrated no difference in the anatomical outcome between both groups at month 12 [21].…”