The impact of metabolic parameters on clinical response to VEGF inhibitors for diabetic macular edema

The impact of metabolic parameters on clinical response to VEGF inhibitors for diabetic macular edema

Author Matsuda, Simone Autor UNIFESP Google Scholar
Tam, Tiffany Google Scholar
Singh, Rishi P. Google Scholar
Kaiser, Peter K. Google Scholar
Petkovsek, Dan Google Scholar
Carneiro, Glaucia Autor UNIFESP Google Scholar
Zanella, Maria Teresa Autor UNIFESP Google Scholar
Ehlers, Justis P. Google Scholar
Institution Cleveland Clin Fdn
Universidade Federal de São Paulo (UNIFESP)
Abstract Aims: Evaluate the role of systemic factors on the functional and anatomic outcomes of anti-VEGF therapy for diabetic macular edema (DME).Methods: A retrospective consecutive case series of 124 patients with DME treated with anti-VEGF therapy was collected. the main outcome measures were change in best corrected visual acuity (BCVA) and change central subfield macular thickness (CST) measured with spectral-domain ocular tomography coherence (SD-OCT); and their correlation with clinical findings.Results: Patients with serum hemoglobin A1c values (HbA1c) <= 7.0% had a statistically significant improvement in BCVA (20/66 to 20/43, p < 0.001), and those patients with HBA1c > 7.0% also had a significant but less robust improvement in BCVA (20/78 to 20/62, p = 0.024). CST improved significantly in both groups, but showed a larger magnitude of improvement in the group with better DM control [-140.7 microns (p < 0.001) and -83.3 microns (p < 0.001)]. Mean HBA1c levels remained relatively stable during the follow-up in both groups, but patients with improved glucose control during the study duration had a significantly lower retinal thickness than patients that had a stable or worsening HbA1c (mean final CST of 324.3 versus 390.0 mu m, respectively, p = 0.042). Other systemic parameters were not correlated with changes in OCT thickness or BCVA. There was not a significant difference related to number of intravitreal injection in the HbA1c <= 7.0% group compared to HbA1c > 7.0% group, mean of 5.48 and 6.0 intravitreal injections respectively (p = 0.362).Conclusion: This study suggests that glucose regulation can impact the response to anti-VEGF therapy in the management of DME. (C) 2014 Elsevier Inc. All rights reserved.
Keywords HbA1c
Metabolic parameters
Diabetic retinopathy
Diabetic macular edema
Avastin
Bevacizumab
VEGF
VEGF-inhibitors
Language English
Sponsor Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)
Grant number CAPES: 1541-12-9
Date 2014-03-01
Published in Journal of Diabetes and Its Complications. New York: Elsevier B.V., v. 28, n. 2, p. 166-170, 2014.
ISSN 1056-8727 (Sherpa/Romeo, impact factor)
Publisher Elsevier B.V.
Extent 166-170
Origin http://dx.doi.org/10.1016/j.jdiacomp.2013.11.009
Access rights Closed access
Type Article
Web of Science ID WOS:000333542900013
URI http://repositorio.unifesp.br/handle/11600/37491

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