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[糖尿病性黄斑水肿治疗反应的神经退行性生物标志物]

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

作者信息

Petrachkov D V, Budzinskaya M V, Pavlov V G, Durzhinskaya M H, Khalatyan A S

机构信息

Research Institute of Eye Diseases, Moscow, Russia.

出版信息

Vestn Oftalmol. 2020;136(4. Vyp. 2):201-206. doi: 10.17116/oftalma2020136042201.

Abstract

UNLABELLED

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

PURPOSE

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

MATERIAL AND METHODS

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).

RESULTS

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.

CONCLUSION

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.

摘要

未标注

目前尚无可靠的生物标志物可用于预测糖尿病性黄斑水肿(DME)的治疗反应。

目的

评估神经退行性生物标志物对DME抗VEGF治疗反应的预测作用。

材料与方法

对14例(20只眼)DME患者进行检查和治疗。根据糖尿病类型将眼睛分为2组:1型糖尿病6只眼,2型糖尿病14只眼。糖尿病病程为16.5±7.9年,糖化血红蛋白水平为8.4±2%。使用光学相干断层扫描(OCT)评估多项指标,以确定抗VEGF治疗反应的神经退行性生物标志物。所有患者均接受阿柏西普的标准负荷疗程(5次玻璃体内注射)。

结果

治疗疗程后,最佳矫正视力(BCVA)显著改善,视网膜中央厚度(CRT)降低。数据分析显示治疗的功能结果与视网膜的以下病理变化之间存在相关性:视网膜神经纤维层(RNFL)厚度、黄斑区神经节细胞和内丛状层复合体(GCL+)厚度、黄斑区RNFL和GCL+复合体(GCL++)厚度、ΔCRT,以及BCVA、患者年龄和糖尿病类型。解剖学结果与糖尿病视网膜病变的阶段、RNFL、GCL+、GCL++、治疗前椭圆体区完整性的破坏相关。

结论

已确定玻璃体内注射阿柏西普药物的疗程是治疗具有临床意义的DME患者的有效方法。已确定抗VEGF药物治疗反应的神经退行性生物标志物:视乳头周围RNFL、GCL+和GCL ++的厚度,以及椭圆体区的完整性。

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