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Jee D, Park S, Kwon JW. Subretinal fluid in macular edema secondary to branch retinal vein occlusion. Sci Rep 2024; 14:13623. [PMID: 38871805 PMCID: PMC11176314 DOI: 10.1038/s41598-024-64047-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2024] [Accepted: 06/04/2024] [Indexed: 06/15/2024] Open
Abstract
We identified characteristics of patients with subretinal fluid (SRF) in macular edema (ME) secondary to branch retinal vein occlusion (BRVO) and determined their clinical outcomes after anti-vascular endothelial growth factor (VEGF) treatment. Fifty-seven eyes of BRVO patients with ME were divided into two groups according to the presence or absence of SRF at diagnosis. We compared the aqueous profiles, ocular and systemic characteristics at baseline, and the clinical outcomes. The SRF group had significantly greater central subfield thickness (CST) values and poorer best-corrected visual acuity (BCVA) at baseline compared to the non-SRF group. The former group had significantly higher aqueous levels of interleukin-8, VEGF, and placental growth factor. CST reduction and BCVA improvement during treatment were significantly greater in the SRF group than in the non-SRF group. Consequently, CST values were significantly lower in the SRF group than in the non-SRF group at 12 months, when BCVA did not differ significantly between the two groups. The SRF group required more frequent anti-VEGF treatment over 12 months and exhibited a higher rate of macular atrophy. Based on the aqueous profiles and the number of treatments required, the presence of SRF in BRVO patients appears to be associated with higher disease activity.
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Affiliation(s)
- Donghyun Jee
- Department of Ophthalmology and Visual Science, St. Vincent's Hospital, College of Medicine, the Catholic University of Korea, Seoul, Korea
| | - Soyoung Park
- Department of Ophthalmology and Visual Science, St. Vincent's Hospital, College of Medicine, the Catholic University of Korea, Seoul, Korea
| | - Jin-Woo Kwon
- Department of Ophthalmology and Visual Science, St. Vincent's Hospital, College of Medicine, the Catholic University of Korea, Seoul, Korea.
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Choi J, Kim SJ, Kang SW, Hwang S, Son KY. Biomarkers determining treatment interval of diabetic macular edema after initial resolution by anti-vascular endothelial growth factor. Graefes Arch Clin Exp Ophthalmol 2024; 262:421-429. [PMID: 37843565 DOI: 10.1007/s00417-023-06269-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Revised: 09/20/2023] [Accepted: 09/27/2023] [Indexed: 10/17/2023] Open
Abstract
PURPOSE To identify predictive factors that help determine the interval of intravitreal anti-vascular endothelial growth factor (anti-VEGF) injection after the initial resolution of diabetic macular edema (DME). METHODS This retrospective case-control study enrolled treatment-naïve DME patients who had achieved DME resolution after intravitreal anti-VEGF injections. Patients were classified into the recurrence and no-recurrence groups, depending on the development of recurrent DME after deferring intravitreal anti-VEGF injection. The demographics and clinical features, including optical coherence tomography findings, were compared between the two groups. RESULTS We enrolled 105 eyes. Sixty eyes (57.1%) belonged to the no-recurrence group, and 45 (42.9%), belonged to the recurrence group. The severity of diabetic retinopathy at baseline was related to early DME recurrence (P = 0.009). At the treatment deferring point, the non-recurrence group had both thinner central subfield thickness (289.5 ± 27.2 μm vs. 307.0 ± 38.2 μm, P = 0.011) and thinner central retinal thickness (214.9 ± 41.4 μm vs. 231.8 ± 41.2 μm, P = 0.043) compared to the recurrence group. Intraretinal cyst was observed in 34 eyes (56.7%) in the no-recurrence group and 42 eyes (93.3%) in the recurrence group at the deferring point (P < 0.001). CONCLUSION A low risk of early DME recurrence is anticipated in the eyes with foveal thinning and no intraretinal cyst when anti-VEGF injection is deferred. These predictive biomarkers can be useful for patient monitoring and determining treatment strategies for DME patients.
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Affiliation(s)
- Jaehwan Choi
- Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Sang Jin Kim
- Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Se Woong Kang
- Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
| | - Sungsoon Hwang
- Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Ki Young Son
- Department of Ophthalmology, Chungnam National University Sejong Hospital, Sejong, South Korea
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Chung YR, Woo TK, Park HR, Lee K. Efficacy of as-needed intravitreal injection compared to 3-monthly loading of anti-vascular endothelial growth factor agents for branch retinal vein occlusion. Sci Rep 2023; 13:12068. [PMID: 37495760 PMCID: PMC10372086 DOI: 10.1038/s41598-023-39303-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Accepted: 07/23/2023] [Indexed: 07/28/2023] Open
Abstract
We investigated the efficacy of intravitreal injection of anti-vascular endothelial growth factor (VEGF) agents in branch retinal vein occlusion (BRVO). Databases, including PubMed, EMBASE, and the Cochrane Library, were searched on November 11, 2022. Studies comparing the pro-re-nata (PRN) regimen after the first treatment (PRN group) to three consecutive monthly injection regimens followed by the PRN regimen (3 + PRN group) were investigated. The primary outcomes were the change in best-corrected visual acuity (BCVA) and the change in central retinal thickness (CRT), with the secondary outcome being the injection frequency. Among 195 reports on anti-VEGF treatment, six comparative studies were included in this meta-analysis. The two groups had no statistically significant differences in terms of BCVA or CRT. However, the total number of injections during follow-up was significantly lower in the PRN group than in the 3 + PRN group (95% CI - 2.09 to - 0.83). The as-needed injection regimen is as effective as 3-monthly loading in terms of anatomical and functional improvement for BRVO, along with a lower treatment burden for patients and physicians.
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Affiliation(s)
- Yoo-Ri Chung
- Department of Ophthalmology, Ajou University School of Medicine, 164 World Cup-Ro, Yeongtong-Gu, Suwon, 16499, Korea
| | - Tae Kyoung Woo
- Department of Ophthalmology, Ajou University School of Medicine, 164 World Cup-Ro, Yeongtong-Gu, Suwon, 16499, Korea
| | - Ha Ryung Park
- Department of Ophthalmology, Ajou University School of Medicine, 164 World Cup-Ro, Yeongtong-Gu, Suwon, 16499, Korea
| | - Kihwang Lee
- Department of Ophthalmology, Ajou University School of Medicine, 164 World Cup-Ro, Yeongtong-Gu, Suwon, 16499, Korea.
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PARAFOVEAL INNER RETINAL THINNING AS THE BIOMARKER PREDICTING LESS RECURRENCE OF MACULAR EDEMA IN CENTRAL RETINAL VEIN OCCLUSION AFTER DISCONTINUING ANTIVASCULAR ENDOTHELIAL GROWTH FACTOR. Retina 2022; 42:2336-2345. [DOI: 10.1097/iae.0000000000003616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Xu F, Yu X, Gao Y, Ning X, Huang Z, Wei M, Zhai W, Zhang R, Wang S, Li J. Predicting OCT images of short-term response to anti-VEGF treatment for retinal vein occlusion using generative adversarial network. Front Bioeng Biotechnol 2022; 10:914964. [PMID: 36312556 PMCID: PMC9596772 DOI: 10.3389/fbioe.2022.914964] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Accepted: 09/23/2022] [Indexed: 11/26/2022] Open
Abstract
To generate and evaluate post-therapeutic optical coherence tomography (OCT) images based on pre-therapeutic images with generative adversarial network (GAN) to predict the short-term response of patients with retinal vein occlusion (RVO) to anti-vascular endothelial growth factor (anti-VEGF) therapy. Real-world imaging data were retrospectively collected from 1 May 2017, to 1 June 2021. A total of 515 pairs of pre-and post-therapeutic OCT images of patients with RVO were included in the training set, while 68 pre-and post-therapeutic OCT images were included in the validation set. A pix2pixHD method was adopted to predict post-therapeutic OCT images in RVO patients after anti-VEGF therapy. The quality and similarity of synthetic OCT images were evaluated by screening and evaluation experiments. We quantitatively and qualitatively assessed the prognostic accuracy of the synthetic post-therapeutic OCT images. The post-therapeutic OCT images generated by the pix2pixHD algorithm were comparable to the actual images in edema resorption response. Retinal specialists found most synthetic images (62/68) difficult to differentiate from the real ones. The mean absolute error (MAE) of the central macular thickness (CMT) between the synthetic and real OCT images was 26.33 ± 15.81 μm. There was no statistical difference in CMT between the synthetic and the real images. In this retrospective study, the application of the pix2pixHD algorithm objectively predicted the short-term response of each patient to anti-VEGF therapy based on OCT images with high accuracy, suggestive of its clinical value, especially for screening patients with relatively poor prognosis and potentially guiding clinical treatment. Importantly, our artificial intelligence-based prediction approach’s non-invasiveness, repeatability, and cost-effectiveness can improve compliance and follow-up management of this patient population.
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Affiliation(s)
- Fabao Xu
- Department of Ophthalmology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Xuechen Yu
- Department of Ophthalmology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Yang Gao
- School of Physics, Beihang University, Beijing, China
- Hangzhou Innovation Institute, Beihang University, Hangzhou, China
| | - Xiaolin Ning
- Hangzhou Innovation Institute, Beihang University, Hangzhou, China
- Research Institute of Frontier Science, Beihang University, Beijing, China
| | - Ziyuan Huang
- Research Institute of Frontier Science, Beihang University, Beijing, China
| | - Min Wei
- Department of Ophthalmology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Weibin Zhai
- Department of Ophthalmology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Rui Zhang
- Department of Ophthalmology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Shaopeng Wang
- Department of Ophthalmology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Jianqiao Li
- Department of Ophthalmology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
- *Correspondence: Jianqiao Li,
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