[Neurodegenerative biomarkers of the response to diabetic macular edema treatment]

There are currently no reliable biomarkers for predicting the response to treatment of diabetic macula edema (DME).

To asses the predictive role of neurodegenerative biomarker of the response to anti-VEGF therapy of DME.

Examination and treatment was carried out on 14 patients (20 eyes) with DME. The eyes were divided into 2 groups by the type of diabetes: 6 eyes with type 1 diabetes and 14 eyes with type 2 diabetes. The duration of diabetes was 16.5±7.9 years, the level of glycated hemoglobin was 8.4±2%. A number of indicators were evaluated using optical coherence tomography (OCT) in order to determine the neurodegenerative biomarkers of the response to anti-VEGF treatment. All patients underwent standard loading course of Aflibercept (5 intravitreal injections).

Significant improvement in Best Corrected Visual Acuity (BCVA) and decrease of central retinal thickness (CRT) was seen after the treatment course. Data analysis revealed a correlation between functional outcomes of the treatment, and the following pathological changes in the retina: thickness of retinal nerve fiber layer (RNFL), thickness of the complex of ganglion cell and inner plexiform layers in the macular region (GCL+), thickness of the RNFL and GCL+ complex (GCL++) in the macular region, ΔCRT, as well as BCVA, patient age, and type of diabetes. Anatomical outcomes correlate with the stage of diabetic retinopathy, RNFL, GCL+, GCL++, violation of the integrity of the ellipsoid zone before treatment.

The course of intravitreal administration of the Aflibercept drug has been established to be an effective method of treating patients with clinically significant DME. Neurodegenerative biomarkers of the response to the anti-VEGF drug therapy have been determined: thickness of the peripapillary RNFL, GCL+ and GCL ++, as well as integrity of the ellipsoid zone.