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Biomarkers determining treatment interval of diabetic macular edema after initial resolution by anti-vascular endothelial growth factor

  • Retinal Disorders
  • Published:
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Abstract

Purpose

To identify predictive factors that help determine the interval of intravitreal anti-vascular endothelial growth factor (anti-VEGF) injection after the initial resolution of diabetic macular edema (DME).

Methods

This retrospective case–control study enrolled treatment-naïve DME patients who had achieved DME resolution after intravitreal anti-VEGF injections. Patients were classified into the recurrence and no-recurrence groups, depending on the development of recurrent DME after deferring intravitreal anti-VEGF injection. The demographics and clinical features, including optical coherence tomography findings, were compared between the two groups.

Results

We enrolled 105 eyes. Sixty eyes (57.1%) belonged to the no-recurrence group, and 45 (42.9%), belonged to the recurrence group. The severity of diabetic retinopathy at baseline was related to early DME recurrence (P = 0.009). At the treatment deferring point, the non-recurrence group had both thinner central subfield thickness (289.5 ± 27.2 μm vs. 307.0 ± 38.2 μm, P = 0.011) and thinner central retinal thickness (214.9 ± 41.4 μm vs. 231.8 ± 41.2 μm, P = 0.043) compared to the recurrence group. Intraretinal cyst was observed in 34 eyes (56.7%) in the no-recurrence group and 42 eyes (93.3%) in the recurrence group at the deferring point (P < 0.001).

Conclusion

A low risk of early DME recurrence is anticipated in the eyes with foveal thinning and no intraretinal cyst when anti-VEGF injection is deferred. These predictive biomarkers can be useful for patient monitoring and determining treatment strategies for DME patients.

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Authors and Affiliations

  1. Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea

    Jaehwan Choi, Sang Jin Kim, Se Woong Kang & Sungsoon Hwang

  2. Department of Ophthalmology, Chungnam National University Sejong Hospital, Sejong, South Korea

    Ki Young Son

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Contributions

- Concepts and design: Se Woong Kang, Jaehwan Choi

- Acquisition, analysis, or interpretation of the data: Jaehwan Choi, Sungsoon Hwang, Ki Young Son

- Drafting of the manuscript: Jaehwan Choi

- Critical revision of the manuscript for important intellectual content: Se Woong Kang, Sang Jin Kim

- Administration, technical, or material support: Sang Jin Kim

- Supervision: Se Woong Kang

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Correspondence to Se Woong Kang.

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This research followed the tenets of the Declaration of Helsinki and was approved by Institutional Review Board (IRB) of the Samsung Medical Center, Seoul, South Korea Informed consent was waived by the board as the research was retrospective, anonymous, and presented no threat to the rights and welfare of the research participants.

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Choi, J., Kim, S.J., Kang, S.W. et al. Biomarkers determining treatment interval of diabetic macular edema after initial resolution by anti-vascular endothelial growth factor. Graefes Arch Clin Exp Ophthalmol 262, 421–429 (2024). https://doi.org/10.1007/s00417-023-06269-w

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