The Role of Intravitreal Corticosteroids in the Treatment of DME: Predictive OCT Biomarkers

Autor:	Marion R. Munk, Gabor Mark Somfai, Marc D. de Smet, Guy Donati, Marcel N. Menke, Justus G. Garweg, Lala Ceklic
Rok vydání:	2022
Předmět:	Vascular Endothelial Growth Factor A Diabetic Retinopathy genetic structures Organic Chemistry 610 Medicine & health Angiogenesis Inhibitors General Medicine eye diseases Catalysis Macular Edema Computer Science Applications Inorganic Chemistry Adrenal Cortex Hormones Intravitreal Injections Humans Physical and Theoretical Chemistry Molecular Biology Spectroscopy Biomarkers Tomography Optical Coherence Retrospective Studies
Zdroj:	Munk, Marion R; Somfai, Gabor Mark; de Smet, Marc D.; Donati, Guy; Menke, Marcel N.; Garweg, Justus; Ceklic, Lala (2022). The Role of Intravitreal Corticosteroids in the Treatment of DME: Predictive OCT Biomarkers. International journal of molecular sciences, 23(14), p. 7585. MDPI 10.3390/ijms23147585
ISSN:	1422-0067
DOI:	10.3390/ijms23147585
Popis:	This work aims to summarize predictive biomarkers to guide treatment choice in DME. Intravitreal anti-VEGF is considered the gold standard treatment for centers involving DME, while intravitreal steroid treatment has been established as a second-line treatment in DME. However, more than 1/3 of the patients do not adequately respond to anti-VEGF treatment despite up to 4-weekly injections. Not surprisingly, insufficient response to anti-VEGF therapy has been linked to low-normal VEGF levels in the serum and aqueous humor. These patients may well benefit from an early switch to intravitreal steroid treatment. In these patients, morphological biomarkers visible in OCT may predict treatment response and guide treatment decisions. Namely, the presence of a large amount of retinal and choroidal hyperreflective foci, disruption of the outer retinal layers and other signs of chronicity such as intraretinal cysts extending into the outer retina and a lower choroidal vascular index are all signs suggestive of a favorable treatment response of steroids compared to anti-VEGF. This paper summarizes predictive biomarkers in DME in order to assist individual treatment decisions in DME. These markers will help to identify DME patients who may benefit from primary dexamethasone treatment or an early switch
Databáze:	OpenAIRE
Externí odkaz:	https://explore.openaire.eu/search/publication?articleId=doi_dedup___::30f892b19e47f5676b708dec9317dab0 https://pubmed.ncbi.nlm.nih.gov/35886930 Zobrazit plný text záznamu Plný text ve formátu PDF Plný text ve formátu HTML
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