Department of Ophthalmology, China Medical University Hospital, China Medical University, Taichung 404333, Taiwan.
Department of General Medicine, College of Medicine, China Medical University Hospital, Taichung 404332, Taiwan.
Medicina (Kaunas). 2023 Mar 21;59(3):629. doi: 10.3390/medicina59030629.
: The identification of possible biomarkers that can predict treatment response among DME eyes is important for the individualization of treatment plans. We investigated optical coherence tomography (OCT)-based biomarkers that may predict the one-year real-life outcomes among diabetic macular edema (DME) eyes following treatment by intravitreal ranibizumab (IVR) injections. A total of 65 eyes from 35 treatment-naïve patients with DME treated with ranibizumab injection were recruited. Best-corrected visual acuity (BCVA), central retinal thickness (CRT), intraocular pressure (IOP), and OCT scans were retrospectively recorded at baseline before treatment and at 3 months, 6 months, and 12 months after treatment. The OCT scans were evaluated for biomarkers of interest, which included central retinal thickness (CRT), amount and locations of hyperreflective foci (HRF), subretinal fluid (SRF), intraretinal cysts (IRC), large outer nuclear layer cyst (LONLC), ellipsoid zone disruption (EZD), disorganization of retinal inner layers (DRIL), hard exudates (HE), epiretinal membrane (ERM), and vitreomacular interface (VMI). Correlations between these OCT biomarkers and outcome measures (visual and structural) were statistically analyzed. A total of 65 eyes from 35 patients with DME were enrolled. The mean age was 64.2 ± 10.9 years old. Significant improvement in terms of mean BCVA ( < 0.005) and mean CRT was seen at final follow-up compared to baseline. The biomarkers of DRIL, LONLC, and SRF were found to be predictive for at least 50 μm CRT reduction after treatment (with odds ratio of 8.69, 8.5, and 17.58, respectively). The biomarkers of IRC, LONLC, and SRF were predictive for significant improvement in terms of BCVA and CRT after treatment. Finally, the number of HRF was predictive for both BCVA improvement and a CRT reduction of less than 100 μm after treatment. No serious complications were reported during the study. Our study demonstrated the utility of OCT biomarkers as therapeutic predictors of ranibizumab treatment among DME eyes.
: 识别可能的生物标志物以预测 DME 眼的治疗反应对于治疗计划的个体化非常重要。我们研究了基于光学相干断层扫描 (OCT) 的生物标志物，这些生物标志物可能可以预测糖尿病性黄斑水肿 (DME) 眼在接受玻璃体内雷珠单抗 (IVR) 注射治疗后的一年真实生活结果。共招募了 35 名未经治疗的 DME 患者的 65 只眼，这些患者接受了雷珠单抗注射治疗。在治疗前、治疗后 3 个月、6 个月和 12 个月，回顾性记录最佳矫正视力 (BCVA)、中央视网膜厚度 (CRT)、眼内压 (IOP) 和 OCT 扫描。OCT 扫描评估了感兴趣的生物标志物，包括中央视网膜厚度 (CRT)、高反射焦点 (HRF) 的数量和位置、视网膜下液 (SRF)、视网膜内囊肿 (IRC)、大外核层囊肿 (LONLC)、椭圆体带中断 (EZD)、视网膜内层紊乱 (DRIL)、硬性渗出物 (HE)、视网膜内界膜 (ERM) 和玻璃体黄斑界面 (VMI)。统计分析了这些 OCT 生物标志物与结局测量值 (视力和结构) 之间的相关性。共纳入 35 名 DME 患者的 65 只眼。平均年龄为 64.2±10.9 岁。与基线相比，最终随访时 BCVA（<0.005）和 CRT 的平均值均有显著改善。DRIL、LONLC 和 SRF 生物标志物在治疗后 CRT 降低至少 50μm 方面具有预测性（比值比分别为 8.69、8.5 和 17.58）。IRC、LONLC 和 SRF 生物标志物在治疗后 BCVA 和 CRT 方面有显著改善。最后，HRF 的数量在治疗后 BCVA 改善和 CRT 降低小于 100μm 方面具有预测性。研究过程中未报告严重并发症。我们的研究表明，OCT 生物标志物可用作 DME 眼雷珠单抗治疗的治疗预测指标。
