Ankoor R Shah1,2, Yoshihiro Yonekawa3,4, Bozho Todorich3,4, Lily Van Laere3, Rehan Hussain5, Maria A Woodward6, Ashkan M Abbey7, Jeremy D Wolfe3,4. 1. Retina Consultants of Houston, Houston, TX. 2. Department of Ophthalmology, Blanton Eye Institute, The Methodist Hospital, Houston, TX. 3. Department of Ophthalmology, Oakland University William Beaumont School of Medicine, Beaumont Eye Institute, Royal Oak, MI. 4. Associated Retinal Consultants, Royal Oak, MI. 5. Department of Ophthalmology, Indiana University School of Medicine, Indianapolis, IN. 6. Department of Ophthalmology, University of Michigan, Ann Arbor, MI. 7. Texas Retina Associates, Dallas, TX.
Abstract
PURPOSE: With multiple anti-vascular endothelial growth factor and steroid therapies available for diabetic macular edema (DME), there is a need for early determination of the best treatment for a particular patient to prevent irreversible vision loss from chronic DME. In this study, we classify patients as responders or non-responders to anti-vascular endothelial growth factor (VEGF) monotherapy in the treatment of DME after a single anti-VEGF injection. METHODS: The study was designed as a single center, retrospective, interventional case series. We included patients who received 3 consecutive monthly injections with the same anti-VEGF agent. We excluded patients who were treated for DME in the preceding 3 months with any form of anti-VEGF therapy. Visual acuity and central retinal thickness (CRT) data were followed for one year. Receiver operating characteristic (ROC) curve analysis was performed in order to identify cutoff values for identifying responders. RESULTS: 107 eyes were reviewed, with 40 eyes of 34 patients meeting all inclusion criteria. Based on ROC curve analysis, a reduction in CRT by > 15% at 1-month, identified eyes that responded to treatment and had a >25% reduction in CRT at 3-months (sensitivity 0.75, specificity 0.92). CONCLUSION: DME eyes that have early response to anti-VEGF treatment by reduction in CRT will have significant response to treatment by 3 months.
PURPOSE: With multiple anti-vascular endothelial growth factor and steroid therapies available for diabetic macular edema (DME), there is a need for early determination of the best treatment for a particular patient to prevent irreversible vision loss from chronic DME. In this study, we classify patients as responders or non-responders to anti-vascular endothelial growth factor (VEGF) monotherapy in the treatment of DME after a single anti-VEGF injection. METHODS: The study was designed as a single center, retrospective, interventional case series. We included patients who received 3 consecutive monthly injections with the same anti-VEGF agent. We excluded patients who were treated for DME in the preceding 3 months with any form of anti-VEGF therapy. Visual acuity and central retinal thickness (CRT) data were followed for one year. Receiver operating characteristic (ROC) curve analysis was performed in order to identify cutoff values for identifying responders. RESULTS: 107 eyes were reviewed, with 40 eyes of 34 patients meeting all inclusion criteria. Based on ROC curve analysis, a reduction in CRT by > 15% at 1-month, identified eyes that responded to treatment and had a >25% reduction in CRT at 3-months (sensitivity 0.75, specificity 0.92). CONCLUSION: DME eyes that have early response to anti-VEGF treatment by reduction in CRT will have significant response to treatment by 3 months.
Authors: Jeremy D Wolfe; Ankoor R Shah; Yoshihiro Yonekawa; Abdulrahman Al Faran; Michael S Franklin; Ashkan M Abbey; Antonio Capone Journal: Eur J Ophthalmol Date: 2015-10-01 Impact factor: 2.597
Authors: David J Browning; Adam R Glassman; Lloyd Paul Aiello; Roy W Beck; David M Brown; Donald S Fong; Neil M Bressler; Ronald P Danis; James L Kinyoun; Quan Dong Nguyen; Abdhish R Bhavsar; Justin Gottlieb; Dante J Pieramici; Michael E Rauser; Rajendra S Apte; Jennifer I Lim; Päivi H Miskala Journal: Ophthalmology Date: 2006-11-21 Impact factor: 12.079
Authors: Patricia Udaondo; Cristina Hernández; Laura Briansó-Llort; Salvador García-Delpech; Olga Simó-Servat; Rafael Simó Journal: J Clin Med Date: 2019-11-02 Impact factor: 4.241