Sen Sagnik, Ramasamy Kim, Sivaprasad Sobha
Department of Retina and Vitreous Services, Aravind Eye Hospital, Madurai 625020, India.
NIHR Moorfields Biomedical Research Centre, Moorfields Eye Hospital, 162, City Road, London EC1V 2PD, UK.
J Pers Med. 2021 May 22;11(6):449. doi: 10.3390/jpm11060449.
Diabetic macular oedema (DMO) is an important cause of moderate vision loss in people with diabetes. Advances in imaging technology have shown that a significant proportion of patients with DMO respond sub-optimally to existing treatment options. Identifying associations and predictors of response before treatment is initiated may help in explaining visual prognosis to patients and aid the development of personalized treatment strategies. Imaging features, such as central subfoveal thickness, photoreceptor integrity, disorganization of retinal inner layers, choroidal changes, and macular perfusion, have been reported to be prognostic factors of visual acuity (VA) in DMO. In this review we evaluated each risk factor to understand their relative importance in visual prognostication of DMO eyes post-treatment. Although individually, some of these factors may not be significant predictors, in combination they may form phenotypes that can inform visual prognosis. Stratification based on these phenotypes needs to be developed to progress to personalized medicine for DMO.
糖尿病性黄斑水肿（DMO）是糖尿病患者中度视力丧失的重要原因。成像技术的进步表明，相当一部分DMO患者对现有治疗方案反应欠佳。在开始治疗前确定反应的关联因素和预测因素，可能有助于向患者解释视力预后情况，并有助于制定个性化治疗策略。据报道，诸如中心凹下厚度、光感受器完整性、视网膜内层紊乱、脉络膜变化和黄斑灌注等成像特征是DMO患者视力（VA）的预后因素。在本综述中，我们评估了每个风险因素，以了解它们在DMO眼治疗后视力预后中的相对重要性。虽然其中一些因素单独可能不是显著的预测因素，但它们组合起来可能形成能够为视力预后提供信息的表型。需要基于这些表型进行分层，以便在DMO的个性化医疗方面取得进展。
