Anti-angiogenic therapy in the treatment of diabetic macular edema in various variants of the vitreoretinal interface
- Authors: Boiko E.V.1, Oskanov D.H.1, Panova I.E.1, Sosnovskii S.V.1, Berezin R.D.1
-
Affiliations:
- S.N. Fyodorov Eye Microsurgery Federal State Institution, St. Petersburg Branch
- Issue: Vol 15, No 4 (2022)
- Pages: 45-52
- Section: Original researches
- URL: https://journals.eco-vector.com/ov/article/view/114733
- DOI: https://doi.org/10.17816/OV114733
- ID: 114733
Cite item
Abstract
BACKGROUND: Anti-angiogenic therapy for diabetic macular edema (DME), recognized as the “gold standard”, is not always effective. When compensating for the general somatic status, it is necessary to search for local causes of DME resistance to anti-angiogenic therapy.
AIM: To study the effectiveness and features of anti-angiogenic therapy for DME in normal and pathological vitreoretinal interface (VRI).
MATERIALS AND METHODS: Patients who received anti-angiogenic therapy for 12 months, in addition to the standard examination, underwent optical coherence tomography with an assessment of morphometric parameters and VRI.
RESULTS: In addition to the groups of normal and pathological VRI, a group of transformation from pathological to normal VRI was identified. Visual acuity increases with normal VRI, decreases with pathological. OCT scores decrease in both groups. In the transformation group, an increase in vision and a decrease in OCT parameters were observed only after VRI transformation.
CONCLUSION: The pathologic condition of the VRI reduces effectiveness of anti-angiogenic therapy for DME, except for 10% of cases in which VRI is transformed into normal within 5-6 months from the start of treatment. These data should be taken into account when choosing a treatment strategy for DME.
Full Text
About the authors
Ernest V. Boiko
S.N. Fyodorov Eye Microsurgery Federal State Institution, St. Petersburg Branch
Email: boiko111@list.ru
ORCID iD: 0000-0002-7413-7478
SPIN-code: 7589-2512
Dr. Sci. (Med.), Professor, Head of the Ophthalmology Department, Corresponding member of the Military Medical Academy, Director
Russian Federation, 21, Yaroslava Gasheka st., Saint Petersburg, 192283Dzhambulat H. Oskanov
S.N. Fyodorov Eye Microsurgery Federal State Institution, St. Petersburg Branch
Author for correspondence.
Email: oskanovd@mail.ru
ORCID iD: 0000-0001-8842-2643
SPIN-code: 9853-5775
Ophthalmologist, Departments of Vitreoretinal Surgery
Russian Federation, 21, Yaroslava Gasheka st., Saint Petersburg, 192283Irina E. Panova
S.N. Fyodorov Eye Microsurgery Federal State Institution, St. Petersburg Branch
Email: eyeren@yandex.ru
ORCID iD: 0000-0001-7443-4555
SPIN-code: 1215-4238
Dr. Sci. (Med.), Professor, Deputy Director for Science
Russian Federation, 21, Yaroslava Gasheka st., Saint Petersburg, 192283Sergei V. Sosnovskii
S.N. Fyodorov Eye Microsurgery Federal State Institution, St. Petersburg Branch
Email: svsosnovsky@mail.ru
ORCID iD: 0000-0001-8969-6240
MD, Cand. Sci. (Med.), Assistant Professor, Ophthalmologist
Russian Federation, 21, Yaroslava Gasheka st., Saint Petersburg, 192283Roman D. Berezin
S.N. Fyodorov Eye Microsurgery Federal State Institution, St. Petersburg Branch
Email: berrom@yandex.ru
ORCID iD: 0000-0003-2745-3547
SPIN-code: 2382-5831
MD, Cand. Sci. (Med.), Ophthalmologist
Russian Federation, 21, Yaroslava Gasheka st., Saint Petersburg, 192283References
- Dedov II, Shestakova MV, Mayorov AYu, et al., eds. Standards of specialized diabetes care. 9th edition. Diabetes mellitus. 2019;22(1S1):1–144. (In Russ.) doi: 10.14341/DM221S1
- Musat O, Cernat C, Labib M, et al. Diabetic macular edema. Rom J Ophthalmol. 2015;59(3):133–136.
- The Diabetic Retinopathy Clinical Research Network; Elman MJ, Aiello LP, Beck RW, et al. Randomized trial evaluating ranibizumab plus prompt or deferred laser or triamcinolone plus prompt laser for diabetic macular edema. Ophthalmology. 2010;117(6):1064–1077. doi: 10.1016/j.ophtha.2010.02.031
- Mitchell P, Bandello F, Schmidt-Erfurth U, et al. The restore study: ranibizumab monotherapy or combined with laser versus laser monotherapy for diabetic macular edema. Ophthalmology. 2011;118(4):615–625. doi: 10.1016/j.ophtha.2011.01.031
- Googe J, Brucker AJ, Bressler N, et al. Diabetic Retinopathy Clinical Research Network: randomized trial evaluating short-term effects of intravitreal ranibizumab or triamcinolone acetonide on macular edema after focal/grid laser for diabetic macular edema in eyes also receiving panretinal photocoagulation. Retina. 2011;31(6):1009–1027. doi: 10.1097/IAE.0b013e318217d739
- Yoon D, Rusu I, Barbazetto I. Reduced effect of anti-vascular endothelial growth factor agents on diabetics with vitreomacular interface abnormalities. Int Ophthalmol. 2014;34(4):817–823. doi: 10.1007/s10792-013-9884-6
- Gatsu MV, Bayborodov YV. Kliniko-topograficheskaya klassifikatsiya diabeticheskikh makulopatiy. Diabetes mellitus. 2008;11(3):20–22. (In Russ.) doi: 10.14341/2072-0351-5353
- Petrachkov DV, Budzinskaya MV, Arzhukhanov DD. The role of internal limiting membrane peeling in the treatment of diabetic macular edema. Vestnik Oftalmologii. 2020;136(4):359366. (In Russ.) doi: 10.17116/oftalma2020136042359
- Faizrakhmanov RR, Bikbov MM, Kalanov MR, Gil’manshin TR. Ehffektivnost’ anti-VEGF-terapii pered vitrehktomiei u patsientov s proliferativnoi stadiei diabeticheskoi retinopatii. Modern technologies in ophthalmology. 2017;(1):310–314. (In Russ.)