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Diabetic Retinopathy

Diabetic Retinopathy

DefinitionDiabetic retinopathy is a microvascular complication of diabetes affecting the retinal blood vessels.Risk FactorsDiabetic retinopathy is present in almost all individuals with type 1 diabetes and more than 60% of those with type 2 diabetes after two decades of disease.The risk increases with poor glycemic control, hypertension, dyslipidemia, smoking, pregnancy, and puberty.Although cataracts and glaucoma are also more frequent in people with diabetes, retinopathy remains the leading...

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Association Between First- and Third-Month Responses to Intravitreal Ranibizumab for Diabetic Macular Edema.

Diego Alejandro Valera-Cornejo^1,2, Verónica Romero-Morales^1,2, Marlon García-Roa^1,2

¹Retina Service, Mexican Institute of Ophthalmology, Querétaro, México.

Journal of Vitreoretinal Diseases

|April 3, 2023

Summary

Early anatomical response to anti-VEGF therapy in diabetic macular edema predicts long-term outcomes. First-month changes in central macular thickness are key indicators for successful treatment of diabetic macular edema.

Keywords:

macular edema optical coherence ranibizumab tomography vascular endothelial growth factors visual acuity

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Area of Science:

Ophthalmology
Retinal Diseases
Medical Treatments

Background:

Diabetic macular edema (DME) is a leading cause of vision loss in diabetic patients.
Anti-vascular endothelial growth factor (anti-VEGF) therapies are standard treatments for DME.
Predicting treatment response is crucial for optimizing patient outcomes.

Purpose of the Study:

To investigate the relationship between early (first-month) and later (third-month) anatomical and visual responses to anti-VEGF therapy in DME.
To identify predictors of treatment success in eyes with center-involved DME.

Main Methods:

Prospective evaluation of 58 eyes with center-involved DME treated with monthly anti-VEGF injections.
Assessment of anatomical response based on central macular thickness (CMT) reduction (≥20%) at 3 months.
Correlation analysis of anatomical response with visual acuity gain, OCT features, and baseline characteristics.

Main Results:

43.1% of eyes achieved ≥20% CMT reduction by month 3.
Early anatomical reduction (≥20% CMT) was associated with favorable baseline factors (e.g., less subretinal fluid, lower HbA1c) and early visual improvement.
First-month CMT change independently predicted third-month anatomical response (P < .05).
First-month visual acuity gain predicted third-month visual outcome (P < .05) but not anatomical response.

Conclusions:

Early anatomical reduction after one month of anti-VEGF therapy is linked to the three-month anatomical response in DME.
First-month visual improvement predicts visual outcomes but not necessarily anatomical changes at three months.