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The relationship between three consecutively repeated intra-vitreal injections with anti-VEGF agents and macular vessel density modifications in Turkish proliferative diabetic retinopathy cases

Year 2024, Volume: 7 Issue: 6, 696 - 702, 27.10.2024

Abstract

Aims: Although a dramatic increase has been observed in Turkish diabetic retinopathy (DR) patients due to the rising cases of diabetes mellitus (DM), ophthalmological advancements facilitate treatment for DM and its ophthalmic complications, such as proliferative diabetic retinopathy (PDR). To determine the effectiveness of the repeated anti-vascular endothelial growth factor (anti-VEGF) intra-vitreal injections (IVI or IVIs) on the macular vascular density (VD) in PDR.
Methods: This theme includes methodological research, retrospective validation studies, and multivariate meta-analysis. The data were obtained from the PubMed, Google Scholar, SCOPUS, WoS, and Google Academic Papers between 2004 and 2023. The injections which completed within 6 months, consecutively administered monthly for three times. This editorial involves diabetic cases that were previously injected with any of Anti-VEGF agent, particularly aflibercept, ranibizumab, and bevacizumab in PDR populace. They were selected over eighteen years who owned high-quality images of “optical coherence tomography angiography” (OCTA). The retinas of thirty-five sufferers from DR were bilaterally analyzed by utilizing keywords.
Results: The analysis of VD relevant to PDR did not identify notable alterations of TCP, DCP and SCP, central retinal vascular layers, both before and after the first anti-VEGF IVI cure. Similar events were detected by the consecutive second and third phases. Besides, central retinal thickness (CRT) decreased at least 10 % from the associated with control cases. Twenty eyes were cure-resistant, whereas fifteen eyes were medical care-responsive. Thirty-five humans with PDR were selected. The gender distribution in the study was sixty percent men and forty percent women, and their average age ranged between forty and eighty.
Conclusion: The article revealed that VD measures did not illustrate any expressive difference in TCP, DCP and SCP before and after three injections. In other words, the baseline VD measurements did not suggestively conclude while CRT was reducing slightly.

Ethical Statement

DOSYASINI YOLLADIM

Supporting Institution

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Thanks

İLGİNİZ İÇİN TEŞEKKÜR EDER, SAYGILARIMI SUNARIM. AYHAN ÖNAL TEL: 507 2110304 E-MAIL: drayhanonal@yahoo.com

References

  • Field M, Buccheri A, King O, et al. Rural health service leaders co‐design state‐wide research addressing an emerging health issue: a case report. Aust J Rural Health. 2022;30:884-890.
  • Babes EE, Bustea C, Behl T, et al. Acute coronary syndromes in diabetic patients, outcome, revascularization, and antithrombotic therapy. Biomed Pharmacotherapy. 2022;148:112772.
  • IDF Diabetes Atlas 10th Edition: Turkey Diabetes report, 2000-2045. Available from: https://diabetesatlas.org/data/en/country/203/tr.html. Accessed July 3, 2024.
  • Tosun A S, Gundogdu N A, Tas F, Ates S. Experiences, thoughts, and feelings of patients with a diabetic foot ulcer in Turkey: a qualitative descriptive study. J Vasc Nurs. 2022;40:140-147.
  • Thomas M. The clustering of cardiovascular, renal, adipo-metabolic eye and liver disease with type 2 diabetes. Metabolism. 2022;128:154961.
  • Kumar Y, Gupta S. Deep transfer learning approaches to predict glaucoma, cataract, choroidal neovascularization, diabetic macular edema, drusen and healthy eyes: an experimental review. Arch Comp Method Eng. 2023;30:521-541.
  • Ulgu M, Gulkesen KH, Akunal A, et al. Characteristics of diabetes mellitus patients in Turkey: an analysis of national electronic health records. Turk J Med Sci. 2023;53:316-322.
  • Ansari P, Tabasumma N, Snigdha NN, et al. Diabetic retinopathy: an overview on mechanisms, pathophysiology, and pharmacotherapy. Diabetology. 2022;3:159-175.
  • Grauslund J. Diabetic retinopathy screening in the emerging era of artificial intelligence. Diabetologia. 2022;65:1415-1423.
  • Zehden JA, Mortensen XM, Reddy A, Zhang AY. Systemic and ocular adverse events with intravitreal anti-VEGF therapy used in the treatment of diabetic retinopathy: a review. Curr Diab Rep. 2022;22:525-536.
  • Bahr TA, Bakri SJ. Update on the management of diabetic retinopathy: anti-vegf agents for the prevention of complications and progression of nonproliferative and proliferative retinopathy. Life (Basel). 2023;13:1098.
  • Uludag G, Hassan M, Matsumiya W, et al. Efficacy and safety of intravitreal anti-VEGF therapy in diabetic retinopathy: what we have learned and what should we learn further?. Expert Opin Biol Ther. 2022;22:1275-1291.
  • Gardner TW, Davila JR. The neurovascular unit and the pathophysiologic basis of diabetic retinopathy. Graefes Arch Clin Exp Ophthalmol. 2017;255:1-6.
  • Yau JW, Rogers SL, Kawasaki R, et al. Global prevalence, and major risk factors of diabetic retinopathy. Diabetes Care. 2012;35:556-564.
  • Pizzarello L, Abiose A, Ffytche T, et al. Vision 2020: the right to sight: a global initiative to eliminate avoidable blindness. Arch Ophthalmol. 2004;122:615-620.
  • Stitt AW, Curtis TM, Chen M, et al. The progress in understanding and treatment of diabetic retinopathy. Prog Retin Eye Res. 2016;51:156-86.
  • Sun JK, Jampol LM. the diabetic retinopathy clinical research network (DRCR. net) and its contributions to the treatment of diabetic retinopathy. Ophthalmic Res. 2019;62:225-230.
  • Boyle J, Vukicevic M, Koklanis K, Itsiopoulos C. Experiences of patients undergoing anti-VEGF treatment for neovascular age-related macular degeneration: a systematic review. Psychol Health Med. 2015;20:296-310.
  • Ghanchi F. The Royal College of Ophthalmologists’ clinical guidelines for diabetic retinopathy: a summary. Eye (Lond). 2013;27:285-287.
  • Pramanik S, Mondal LK, Paine SK, et al. Efficacy and cost-effectiveness of anti-VEGF for treating diabetic retinopathy in the Indian population. Clin Ophthalmol. 2021;3341-3350.
  • Azad R, Chandra P, Gupta R. The economic implications of the use of anti-vascular endothelial growth factor drugs in age-related macular degeneration. Indian J Ophthalmol. 2007;55:441.
  • Wells JA, Glassman AR, Ayala AR, et al. Aflibercept, bevacizumab, or ranibizumab for diabetic macular edema. N Eng J Med. 2015;372:1193-1203.
  • Blankenship G W. Fifteen-year argon laser and xenon photocoagulation results of Bascom Palmer Eye Institute’s patients participating in the diabetic retinopathy study. Ophthalmology. 1991;98:125-128.
  • Mirshahi A, Roohipoor R, Lashay A, Mohammadi SF, Abdoallahi A, Faghihi H. Bevacizumab-augmented retinal laser photocoagulation in proliferative diabetic retinopathy: a randomized double-masked clinical trial. Eur J Ophthalmol. 2008;18:263-269.
  • Zhao Y, Singh RP. The role of anti-vascular endothelial growth factor (anti-VEGF) in the management of proliferative diabetic retinopathy. Drugs Context. 2018;7:212532
  • Aaltonen K, Kujala J. A project lifecycle perspective on stakeholder influence strategies in global projects. Scandinav J Manag. 2019; 26:381-397.
  • Sorour OA, Sabrosa AS, Yasin Alibhai A, et al. Optical coherence tomography angiography analysis of macular vessel density before and after anti-VEGF therapy in eyes with diabetic retinopathy. Int Ophthalmol. 2019;39:2361-2371.
  • Zhao H, Yu M, Zhou L, Li C, Lu L, Jin C. Comparison of the effect of pan-retinal photocoagulation and intravitreal conbercept treatment on the change of retinal vessel density monitored by optical coherence tomography angiography in patients with proliferative diabetic retinopathy. J Clin Med. 2021;10:4484.
  • Chatziralli I, Touhami S, Cicinelli MV, et al. Disentangling the association between retinal non-perfusion and anti-VEGF agents in diabetic retinopathy. Eye (Lond). 2022;36:692-703.
  • Mirshahi R, Falavarjani KG, Molaei S, et al. Macular microvascular changes after intravitreal bevacizumab injection in diabetic macular edema. Canadian J Ophthalmol. 2021;56:57-65.
Year 2024, Volume: 7 Issue: 6, 696 - 702, 27.10.2024

Abstract

References

  • Field M, Buccheri A, King O, et al. Rural health service leaders co‐design state‐wide research addressing an emerging health issue: a case report. Aust J Rural Health. 2022;30:884-890.
  • Babes EE, Bustea C, Behl T, et al. Acute coronary syndromes in diabetic patients, outcome, revascularization, and antithrombotic therapy. Biomed Pharmacotherapy. 2022;148:112772.
  • IDF Diabetes Atlas 10th Edition: Turkey Diabetes report, 2000-2045. Available from: https://diabetesatlas.org/data/en/country/203/tr.html. Accessed July 3, 2024.
  • Tosun A S, Gundogdu N A, Tas F, Ates S. Experiences, thoughts, and feelings of patients with a diabetic foot ulcer in Turkey: a qualitative descriptive study. J Vasc Nurs. 2022;40:140-147.
  • Thomas M. The clustering of cardiovascular, renal, adipo-metabolic eye and liver disease with type 2 diabetes. Metabolism. 2022;128:154961.
  • Kumar Y, Gupta S. Deep transfer learning approaches to predict glaucoma, cataract, choroidal neovascularization, diabetic macular edema, drusen and healthy eyes: an experimental review. Arch Comp Method Eng. 2023;30:521-541.
  • Ulgu M, Gulkesen KH, Akunal A, et al. Characteristics of diabetes mellitus patients in Turkey: an analysis of national electronic health records. Turk J Med Sci. 2023;53:316-322.
  • Ansari P, Tabasumma N, Snigdha NN, et al. Diabetic retinopathy: an overview on mechanisms, pathophysiology, and pharmacotherapy. Diabetology. 2022;3:159-175.
  • Grauslund J. Diabetic retinopathy screening in the emerging era of artificial intelligence. Diabetologia. 2022;65:1415-1423.
  • Zehden JA, Mortensen XM, Reddy A, Zhang AY. Systemic and ocular adverse events with intravitreal anti-VEGF therapy used in the treatment of diabetic retinopathy: a review. Curr Diab Rep. 2022;22:525-536.
  • Bahr TA, Bakri SJ. Update on the management of diabetic retinopathy: anti-vegf agents for the prevention of complications and progression of nonproliferative and proliferative retinopathy. Life (Basel). 2023;13:1098.
  • Uludag G, Hassan M, Matsumiya W, et al. Efficacy and safety of intravitreal anti-VEGF therapy in diabetic retinopathy: what we have learned and what should we learn further?. Expert Opin Biol Ther. 2022;22:1275-1291.
  • Gardner TW, Davila JR. The neurovascular unit and the pathophysiologic basis of diabetic retinopathy. Graefes Arch Clin Exp Ophthalmol. 2017;255:1-6.
  • Yau JW, Rogers SL, Kawasaki R, et al. Global prevalence, and major risk factors of diabetic retinopathy. Diabetes Care. 2012;35:556-564.
  • Pizzarello L, Abiose A, Ffytche T, et al. Vision 2020: the right to sight: a global initiative to eliminate avoidable blindness. Arch Ophthalmol. 2004;122:615-620.
  • Stitt AW, Curtis TM, Chen M, et al. The progress in understanding and treatment of diabetic retinopathy. Prog Retin Eye Res. 2016;51:156-86.
  • Sun JK, Jampol LM. the diabetic retinopathy clinical research network (DRCR. net) and its contributions to the treatment of diabetic retinopathy. Ophthalmic Res. 2019;62:225-230.
  • Boyle J, Vukicevic M, Koklanis K, Itsiopoulos C. Experiences of patients undergoing anti-VEGF treatment for neovascular age-related macular degeneration: a systematic review. Psychol Health Med. 2015;20:296-310.
  • Ghanchi F. The Royal College of Ophthalmologists’ clinical guidelines for diabetic retinopathy: a summary. Eye (Lond). 2013;27:285-287.
  • Pramanik S, Mondal LK, Paine SK, et al. Efficacy and cost-effectiveness of anti-VEGF for treating diabetic retinopathy in the Indian population. Clin Ophthalmol. 2021;3341-3350.
  • Azad R, Chandra P, Gupta R. The economic implications of the use of anti-vascular endothelial growth factor drugs in age-related macular degeneration. Indian J Ophthalmol. 2007;55:441.
  • Wells JA, Glassman AR, Ayala AR, et al. Aflibercept, bevacizumab, or ranibizumab for diabetic macular edema. N Eng J Med. 2015;372:1193-1203.
  • Blankenship G W. Fifteen-year argon laser and xenon photocoagulation results of Bascom Palmer Eye Institute’s patients participating in the diabetic retinopathy study. Ophthalmology. 1991;98:125-128.
  • Mirshahi A, Roohipoor R, Lashay A, Mohammadi SF, Abdoallahi A, Faghihi H. Bevacizumab-augmented retinal laser photocoagulation in proliferative diabetic retinopathy: a randomized double-masked clinical trial. Eur J Ophthalmol. 2008;18:263-269.
  • Zhao Y, Singh RP. The role of anti-vascular endothelial growth factor (anti-VEGF) in the management of proliferative diabetic retinopathy. Drugs Context. 2018;7:212532
  • Aaltonen K, Kujala J. A project lifecycle perspective on stakeholder influence strategies in global projects. Scandinav J Manag. 2019; 26:381-397.
  • Sorour OA, Sabrosa AS, Yasin Alibhai A, et al. Optical coherence tomography angiography analysis of macular vessel density before and after anti-VEGF therapy in eyes with diabetic retinopathy. Int Ophthalmol. 2019;39:2361-2371.
  • Zhao H, Yu M, Zhou L, Li C, Lu L, Jin C. Comparison of the effect of pan-retinal photocoagulation and intravitreal conbercept treatment on the change of retinal vessel density monitored by optical coherence tomography angiography in patients with proliferative diabetic retinopathy. J Clin Med. 2021;10:4484.
  • Chatziralli I, Touhami S, Cicinelli MV, et al. Disentangling the association between retinal non-perfusion and anti-VEGF agents in diabetic retinopathy. Eye (Lond). 2022;36:692-703.
  • Mirshahi R, Falavarjani KG, Molaei S, et al. Macular microvascular changes after intravitreal bevacizumab injection in diabetic macular edema. Canadian J Ophthalmol. 2021;56:57-65.
There are 30 citations in total.

Details

Primary Language English
Subjects Ophthalmology, Ophthalmology and Optometry (Other)
Journal Section Original Article
Authors

Ayhan Önal 0000-0003-3637-0495

Publication Date October 27, 2024
Submission Date September 11, 2024
Acceptance Date October 22, 2024
Published in Issue Year 2024 Volume: 7 Issue: 6

Cite

AMA Önal A. The relationship between three consecutively repeated intra-vitreal injections with anti-VEGF agents and macular vessel density modifications in Turkish proliferative diabetic retinopathy cases. J Health Sci Med / JHSM. October 2024;7(6):696-702.

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