Please use this identifier to cite or link to this item: http://hdl.handle.net/1822/58083

TitleSerological inflammatory factors as biomarkers for anatomic response in diabetic macular edema treated with anti-VEGF
Author(s)Brito, Pedro
Costa, Jorge
Gomes, Nuno
Costa, Sandra
Correia-Pinto, Jorge
Silva, Rufino
KeywordsAnti-VEGF
Bevacizumab
C-reactive protein
Diabetic macular edema
Inflammatory biomarkers
Issue dateJul-2018
PublisherElsevier Science Inc
JournalJournal of Diabetes and Its Complications
CitationBrito, P., Costa, J., Gomes, N., Costa, S., Correia-Pinto, J., & Silva, R. (2018). Serological inflammatory factors as biomarkers for anatomic response in diabetic macular edema treated with anti-VEGF. Journal of diabetes and its complications
Abstract(s)To study the relationship between systemic pro-inflammatory factors and macular structural response to intravitreal bevacizumab for diabetic macular edema (DME).
Purpose To study the relationship between systemic pro-inflammatory factors and macular structural response to intravitreal bevacizumab for diabetic macular edema (DME). Methods Prospective study including 30 cases with DME, treated with bevacizumab and a minimum follow-up of 6 months. All cases underwent baseline laboratory testing for cardiovascular risk (high sensitivity C-reactive protein (hsCRP), homocystein), dyslipidemia, renal dysfunction and glucose control. Serum levels of VEGF, soluble ICAM-1, MCP-1 and TNF-α were assessed by enzyme-linked immunosorbent assay kits. Significant associations between systemic factors and quantitative and qualitative spectral-domain optical coherence macular features were analyzed. Results A mean of 4.82 ± 0.56 intravitreal injections was performed, resulting in significant improvement of central foveal thickness (CFT) (p < 0.001). A significant association with third month CFT decrease <10% was found for hsCRP (3.33 ± 2.01 vs 1.39 ± 1.15 mg/l, p = 0.007) and ICAM1 (975.54 ± 265.49 vs 727.07 ± 336.09 pg/ml, p = 0.012). ROC curve analysis indicated hsCRP and ICAM1 as significant biomarkers for 3rd month reduced anatomic response (area under the curve (AUC) = 0.807, p = 0.009 for hsCRP; AUC = 0.788, p = 0.014 for ICAM1). ROC curve analysis revealed hsCRP as a significant biomarker for 6th month CFT decrease <10% (AUC = 0.903, p < 0.001, cutoff value = 1.81 mg/l). A significant association with 6th month CFT decrease ≥25% was found for serum MCP1 (244.69 ± 49.34 pg/ml vs 319.24 ± 94.88 pg/ml, p = 0.017) and serum VEGF (90.84 ± 37.33 vs 58.28 ± 25.19 pg/ml, p = 0.027). The combined model of serum VEGF and LDL-cholesterol was found to be predictive of 6th month hard exudate severity (p = 0.001, r2 = 0.463). Conclusions Increased levels of hsCRP and ICAM1 were found to be significant biomarkers for early reduced anatomic response to anti-VEGF treatment. Cases with higher serum levels of such factors had increased CFT values, despite treatment, suggesting inner blood-retinal barrier breakdown that is not adequately responsive to anti-VEGF monotherapy
TypeArticle
DescriptionAccepted manuscript
URIhttp://hdl.handle.net/1822/58083
DOI10.1016/j.jdiacomp.2018.05.006
ISSN1056-8727
1873-460X
Publisher versionhttps://www.sciencedirect.com/science/article/pii/S105687271830148X
Peer-Reviewedyes
AccessOpen access
Appears in Collections:ICVS - Artigos em Revistas Internacionais com Referee

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