Intravitreal bevacizumab injections for diabetic macular edema – predictors of response: a retrospective study
Lavnish Joshi,1–3 Asaf Bar,4 Oren Tomkins-Netzer,1,3 Satish Yaganti,1 Jiten Morarji,1 Panayiotis Vouzounis,1 Sophie Seguin-Greenstein,1,4 Simon R Taylor,3,5 Sue Lightman1,3 1Department of Clinical Ophthalmology, UCL Institute of Ophthalmology and Moorfields Eye Hospital, London, UK; 2Opht...
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Dove Medical Press
2016
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oai:doaj.org-article:a839380b40654de2a69b482f9aa583b52021-12-02T03:56:53ZIntravitreal bevacizumab injections for diabetic macular edema – predictors of response: a retrospective study1177-5483https://doaj.org/article/a839380b40654de2a69b482f9aa583b52016-10-01T00:00:00Zhttps://www.dovepress.com/intravitreal-bevacizumab-injections-for-diabetic-macular-edema-ndash-p-peer-reviewed-article-OPTHhttps://doaj.org/toc/1177-5483Lavnish Joshi,1–3 Asaf Bar,4 Oren Tomkins-Netzer,1,3 Satish Yaganti,1 Jiten Morarji,1 Panayiotis Vouzounis,1 Sophie Seguin-Greenstein,1,4 Simon R Taylor,3,5 Sue Lightman1,3 1Department of Clinical Ophthalmology, UCL Institute of Ophthalmology and Moorfields Eye Hospital, London, UK; 2Ophthalmology Department, Ashford & St Peter’s NHS Foundation Trust, Ashford, Middlesex, UK; 3Ophthalmology Department, Royal Surrey County Hospital NHS Foundation Trust, Guildford, Surrey, UK; 4Ophthalmology Department, Wolfson Medical Center, Holon Israel; 5Ophthalmology Department, University of Surrey, Guildford, Surrey, UK Background: Outcomes of intravitreal antivascular endothelial growth factor injections are variable among patients with diabetic macular edema (DME). The aim of this study was to determine the ocular and systemic predictors of DME response to intravitreal bevacizumab (IVB). Methods: Retrospective review over 2 years of 78 eyes from 54 patients. An anatomical response to IVB was defined as a 20% reduction in central macula thickness after the first course (three injections) of IVB. Results: Twenty-eight percent of patients had an anatomical response after the first course of IVB. Systemic hypertension (odds ratio, 95% confidence interval: 12.1, 0.7–21) was a statistically significant predictor (P=0.025) of a good response to IVB, whereas previous macular laser was a statistically significant (P=0.0005) predictor of a poor response (0.07, 0.01–0.32). Sixty-eight percent of eyes underwent subsequent treatment for DME after the first course of IVB. The visual acuity gain at 24 months in hypertensive (0.7±3.6 letters) and nonhypertensive (5.2±3.7 letters) patients was not significantly different (P=0.41). Conclusion: Hypertension and previous macular laser were positive and negative predictors of response to IVB, respectively. However, long-term visual acuity changes were not significantly different between eyes with and without systemic hypertension. Keywords: diabetes, macular edema, intravitreal therapyJoshi LBar ATomkins-Netzer OYaganti SMorarji JVouzounis PSeguin-Greenstein STaylor SRLightman SDove Medical PressarticleDiabetesmacular edemaintravitreal therapyOphthalmologyRE1-994ENClinical Ophthalmology, Vol Volume 10, Pp 2093-2098 (2016) |
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Diabetes macular edema intravitreal therapy Ophthalmology RE1-994 |
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Diabetes macular edema intravitreal therapy Ophthalmology RE1-994 Joshi L Bar A Tomkins-Netzer O Yaganti S Morarji J Vouzounis P Seguin-Greenstein S Taylor SR Lightman S Intravitreal bevacizumab injections for diabetic macular edema – predictors of response: a retrospective study |
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Lavnish Joshi,1–3 Asaf Bar,4 Oren Tomkins-Netzer,1,3 Satish Yaganti,1 Jiten Morarji,1 Panayiotis Vouzounis,1 Sophie Seguin-Greenstein,1,4 Simon R Taylor,3,5 Sue Lightman1,3 1Department of Clinical Ophthalmology, UCL Institute of Ophthalmology and Moorfields Eye Hospital, London, UK; 2Ophthalmology Department, Ashford & St Peter’s NHS Foundation Trust, Ashford, Middlesex, UK; 3Ophthalmology Department, Royal Surrey County Hospital NHS Foundation Trust, Guildford, Surrey, UK; 4Ophthalmology Department, Wolfson Medical Center, Holon Israel; 5Ophthalmology Department, University of Surrey, Guildford, Surrey, UK Background: Outcomes of intravitreal antivascular endothelial growth factor injections are variable among patients with diabetic macular edema (DME). The aim of this study was to determine the ocular and systemic predictors of DME response to intravitreal bevacizumab (IVB). Methods: Retrospective review over 2 years of 78 eyes from 54 patients. An anatomical response to IVB was defined as a 20% reduction in central macula thickness after the first course (three injections) of IVB. Results: Twenty-eight percent of patients had an anatomical response after the first course of IVB. Systemic hypertension (odds ratio, 95% confidence interval: 12.1, 0.7–21) was a statistically significant predictor (P=0.025) of a good response to IVB, whereas previous macular laser was a statistically significant (P=0.0005) predictor of a poor response (0.07, 0.01–0.32). Sixty-eight percent of eyes underwent subsequent treatment for DME after the first course of IVB. The visual acuity gain at 24 months in hypertensive (0.7±3.6 letters) and nonhypertensive (5.2±3.7 letters) patients was not significantly different (P=0.41). Conclusion: Hypertension and previous macular laser were positive and negative predictors of response to IVB, respectively. However, long-term visual acuity changes were not significantly different between eyes with and without systemic hypertension. Keywords: diabetes, macular edema, intravitreal therapy |
| format |
article |
| author |
Joshi L Bar A Tomkins-Netzer O Yaganti S Morarji J Vouzounis P Seguin-Greenstein S Taylor SR Lightman S |
| author_facet |
Joshi L Bar A Tomkins-Netzer O Yaganti S Morarji J Vouzounis P Seguin-Greenstein S Taylor SR Lightman S |
| author_sort |
Joshi L |
| title |
Intravitreal bevacizumab injections for diabetic macular edema – predictors of response: a retrospective study |
| title_short |
Intravitreal bevacizumab injections for diabetic macular edema – predictors of response: a retrospective study |
| title_full |
Intravitreal bevacizumab injections for diabetic macular edema – predictors of response: a retrospective study |
| title_fullStr |
Intravitreal bevacizumab injections for diabetic macular edema – predictors of response: a retrospective study |
| title_full_unstemmed |
Intravitreal bevacizumab injections for diabetic macular edema – predictors of response: a retrospective study |
| title_sort |
intravitreal bevacizumab injections for diabetic macular edema – predictors of response: a retrospective study |
| publisher |
Dove Medical Press |
| publishDate |
2016 |
| url |
https://doaj.org/article/a839380b40654de2a69b482f9aa583b5 |
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