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Saori Tanaka, Noriko Miyamoto, Sentaro Kusuhara, Hisashi Iwami, Shogo Yamamoto, Shin Yoshitake, Yuji Hirota, Makoto Nakamura, Masahiro Ikeda, Fumi Gomi, Yasuo Kurimoto; Pretreatment factors in managing protocol with aflibercept in patients with diabetic macular edema. Invest. Ophthalmol. Vis. Sci. 2019;60(9):2604. doi: https://doi.org/.
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Anti-vascular endothelial growth factor (VEGF) agents have been the mainstay of treatment for diabetic macular edema (DME). However, frequent injections of anti-VEGF agent create a burden to both patients and physicians. The predictors of outcome using anti-VEGF agents would be helpful for patients counseling before treatment. Accordingly, we aimed to search pre-treatment factors which can effectively predict visual and structural outcomes after intravitreal aflibercept injection (IVA) for DME.
We retrospectively reviewed the medical records of 32 eyes of 32 patients with DME (14 men and 18 women, the mean age was 66 years) who were treated with IVA (3 monthly induction and as need thereafter) from January 2016 to August 2017 at 3 hospitals in Hyogo Prefecture. We analyzed the correlations between changes in best corrected visual acuity (BCVA) (logMAR unit) or central retinal thickness (CRT) and various pretreatment factors including medical history, blood or urinary test results, and parameters on optical coherence tomography.
There was a significant correlation between the change in BCVA and the history of diabetes mellitus (r=0.443, P=0.012), dyslipidemia (r=0.450, P=0.011), serous retinal detachment (r=-0.390, P=0.027), pars plana vitrectomy (r=-0.392, P=0.026), ellipsoid zone (EZ)（r=-0.399, P=0.024）, and external limiting membrane (ELM) （r=-0.433, P=0.013） at 3 months and ELM（r=-0.351, P=0.049） at 12 months. While, there was a correlation between the change in CRT and sub-Tenon’s injection of triamcinolone acetonide （r=0.416, P=0.018） at 3 months, and dyslipidemia （r=0.548, P=0.001） at 12 months.
In addition to known factors such as EZ and ELM, dyslipidemia showed a close correlation to not only BCVA but also CRT after IVA treatment. Therefore, serum lipid level might be worth being considered before treatment of DME.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.
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