Characteristics of diabetic macular edema patients refractory to anti-VEGF treatments and a dexamethasone implant

English version

Autoři: Moon Young Choi ^aff001; Donghyun Jee ^aff001; Jin-woo Kwon ^aff001
Působiště autorů: Department of Ophthalmology and Visual Science, St. Vincent’s Hospital, College of Medicine, The Catholic University of Korea, Suwon, Korea ^aff001
Vyšlo v časopise: PLoS ONE 14(9)
Kategorie: Research Article
prolekare.web.journal.doi_sk: https://doi.org/10.1371/journal.pone.0222364

Souhrn

Purpose

To determine the characteristics of diabetic macular edema (DME) patients refractory to intravitreal bevacizumab (IVB) treatments and an additional dexamethasone implant.

Methods

We classified 119 DME patients according to whether or not they are responsive to 3 consecutive monthly anti-VEGF treatments and/or an additional dexamethasone implant. We compared their concentrations of IL (interleukin)-1β, IL-8, IL-10, IL-17, placental growth factor (PlGF), and vascular endothelial growth factor (VEGF) in the aqueous humor as well as their optical coherence tomography (OCT) findings, and baseline characteristics. We used logistic regression analyses to identify preoperative factors related to refractoriness to treatments.

Results

Of 119 treatment-naïve DME patients, 50 (42.02%) patients showed responsiveness [central subfield thickness (CST) < 300μm] after 3 IVBs, and 59 (49.58%) patients showed responsiveness after an additional dexamethasone implant, but 10 (8.40%) patients showed CST 300 ≥ μm even after both treatments. Refractory DME patients showed significantly higher number of hyperreflective foci (HF) in the OCT and higher average level of aqueous IL-1β at baseline (p<0.001 and p = 0.042, respectively). In the logistic regression analysis, higher number of HF in the OCT was associated with the refractoriness to both treatments (odds ratio [OR]: 7.03, p = 0.007)

Conclusions

Higher number of HF in the OCT at the initial visit was associated with poor responses to IVBs and an additional dexamethasone implant.

Klíčová slova:

Biology and life sciences – Biochemistry – Bioengineering – Biotechnology – Engineering and technology – Research and analysis methods – Proteins – Medicine and health sciences – Pathology and laboratory medicine – Physiology – Diagnostic medicine – Signs and symptoms – Endocrinology – Endocrine disorders – Metabolic disorders – Immunology – Immune response – Inflammation – Diabetes diagnosis and management – HbA1c – Hemoglobin – Imaging techniques – Medical devices and equipment – Medical implants – Endocrine physiology – Diagnostic radiology – Radiology and imaging – Ophthalmology – Tomography – Edema – Retinal disorders – Retinopathy – Diabetic retinopathy – Placental growth factor

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