Systemic factors associated with poor anatomical response to anti-VEGF therapy in patients with diabetic macular edema: evidence from a large clinical cohort - Summary - MDSpire
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Systemic Influences Linked to Suboptimal Anatomical Outcomes Following Anti-VEGF Treatment in Diabetic Macular Edema Patients: Insights from a Large Clinical Cohort
To identify independent systemic factors associated with poor anatomical response to intravitreal Conbercept in patients with diabetic macular edema (DME).
Approach:
Study Design: Retrospective cohort study analyzing 1,039 eyes from 691 patients with DME who underwent a standardized loading phase of intravitreal Conbercept.
Outcome Measures: Primary outcomes included absolute and percentage change in central macular thickness (CMT) from baseline to one month after the third injection.
Statistical Analysis: Generalized Estimating Equation (GEE) models were used to identify independent factors while accounting for intra-subject correlation.
Key Findings:
Median CMT decreased from 325.00 μm at baseline to 291.00 μm at three months (P < 0.001).
Median best-corrected visual acuity (BCVA) improved from 0.30 to 0.40 (P < 0.001).
431 eyes (41.48%) were classified as responders, while 608 eyes (58.52%) were non-responders.
Baseline CMT, baseline BCVA, LDL-C, fasting blood glucose, and HbA1c were independently associated with CMT reduction.
Lower baseline CMT, higher baseline BCVA, elevated fasting blood glucose, and elevated HbA1c were associated with poor anatomical response.
Interpretation:
Systemic metabolic status, particularly HbA1c and fasting glucose levels, along with baseline ocular morphology, are independently associated with anatomical response to intravitreal Conbercept in DME.
Limitations:
Retrospective design may introduce bias.
Findings may not be generalizable to all DME populations.
Potential confounding factors not accounted for in the analysis.
As his term comes to a close, Geoffrey G. Emerson, MD, PhD, FASRS, discusses scientific advances, physician advocacy, and the collaborative leadership behind ASRS.
