Usui-Ouchi Ayumi, Kishishita Shuta, Sakanishi Yoshihito, Mashimo Keitaro, Tamaki Kazunori, Matsuzawa Moe, Kimura Meiko, Ikari Riyu, Morita Shuu, Ninomiya Ishin, Sakuma Toshiro, Ebihara Nobuyuki, Nakao Shintaro
Department of Ophthalmology, Juntendo University Urayasu Hospital, 2-1-1 Tomioka, Urayasu, Chiba, 279-0021, Japan.
Department of Ophthalmology, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan.
Jpn J Ophthalmol. 2025 Mar;69(2):245-252. doi: 10.1007/s10384-025-01170-x. Epub 2025 Feb 28.
This retrospective observational study aimed to investigate the longitudinal changes in renal function and central macular thickness (CMT) and their impact on visual outcomes during anti-vascular endothelial growth factor (anti-VEGF) therapy for diabetic macular edema (DME).
This study employed a retrospective observational design and analyzed data from treatment-naive patients with DME (62 cases, 100 eyes) receiving anti-VEGF therapy for 36 months. Baseline and follow-up assessments were conducted at 12, 24, and 36 months.
Best corrected visual acuity (BCVA), CMT, number of anti-VEGF injections, HbA1c, serum creatinine (Cre), blood urea nitrogen (BUN), estimated glomerular filtration rate (eGFR), urinary protein levels, and chronic kidney disease (CKD) stage were measured at each time point.
The study population had a mean age of 60.7 ± 12.2 years, with 41 men and 21 women. Over the 36-month period, the mean number of anti-VEGF injections per eye was 5.3 ± 3.3. Maximum CMT significantly decreased at each time point, and final BCVA showed significant improvement (logMAR: - 0.07). HbA1c levels remained stable, BUN and Cre levels increased, and eGFR decreased significantly over time. CKD stage 3+ at 36 months significantly resulted in worse CMT.
This retrospective observational study provides valuable insights into the longitudinal changes in renal function and CMT during anti-VEGF therapy for DME. Our findings emphasize the importance of monitoring renal function. This study contributes to our understanding of the complex relationship between renal function, DME, and anti-VEGF therapy, thereby facilitating improved management and outcomes in patients with DME.
本回顾性观察研究旨在调查糖尿病性黄斑水肿（DME）抗血管内皮生长因子（抗VEGF）治疗期间肾功能和中心黄斑厚度（CMT）的纵向变化及其对视力预后的影响。
本研究采用回顾性观察设计，分析了62例（100只眼）初治DME患者接受抗VEGF治疗36个月的数据。在第12、24和36个月进行基线和随访评估。
在每个时间点测量最佳矫正视力（BCVA）、CMT、抗VEGF注射次数、糖化血红蛋白（HbA1c）、血清肌酐（Cre）、血尿素氮（BUN）、估计肾小球滤过率（eGFR）、尿蛋白水平和慢性肾脏病（CKD）分期。
研究人群的平均年龄为60.7±12.2岁，男性41例，女性21例。在36个月期间，每只眼抗VEGF注射的平均次数为5.3±3.3次。每个时间点的最大CMT均显著降低，最终BCVA显示出显著改善（最小分辨角对数：-0.07）。HbA1c水平保持稳定，BUN和Cre水平随时间显著升高，eGFR显著降低。36个月时CKD 3+期显著导致CMT更差。
本回顾性观察研究为DME抗VEGF治疗期间肾功能和CMT的纵向变化提供了有价值的见解。我们的研究结果强调了监测肾功能的重要性。本研究有助于我们理解肾功能、DME和抗VEGF治疗之间的复杂关系，从而促进DME患者的改善管理和预后。
