医学
阿柏西普
糖尿病性视网膜病变
眼科
荧光血管造影
前瞻性队列研究
视网膜
队列
外科
内科学
糖尿病
贝伐单抗
化疗
内分泌学
作者
Amy Babiuch,Charles C. Wykoff,Jenna Hach,Sunil K. Srivastava,Katherine E. Talcott,Hannah J. Yu,Muneeswar Gupta Nittala,Srinivas R. Sadda,Michael S. Ip,Thuy Le,Ming Hu,Jamie Reese,Justis P. Ehlers
标识
DOI:10.1136/bjophthalmol-2020-316952
摘要
Background/Aims Quantifying microaneurysms (MAs) turnover may be an objective measure for therapeutic response in diabetic retinopathy. This study assesses changes in MA counts on ultra-widefield fluorescein angiography (UWFA) in subjects undergoing treatment with intravitreal aflibercept injection (IAI) for proliferative diabetic retinopathy (PDR) in the Intravit re al Afliber c ept for Retinal N o n-Perfusion in Proliferati v e Diab e tic R etinopath y (RECOVERY) study using an automated MA detection platform. Methods RECOVERY is a prospective study that enrolled 40 subjects with PDR randomised 1:1 to receive 2 mg IAI every 4 weeks(q4wk) or every 12 weeks (q12wk). UWFA images were obtained at baseline, 6 months and 1 year. Images were analysed using an automated segmentation platform to detect and quantify MAs. Zones 1, 2 and 3 correspond to the macula, mid-periphery and far-periphery, respectively. Results The q4wk cohort demonstrated a significant decline in MAs in all zones and panretinally at baseline versus month 6, baseline versus year 1, and month 6 versus year 1 (−20.0% to −61.8%; all p<0.001). In the q12wk cohort, baseline versus month 6 showed a significant decline panretinally (mean: −34.2%; p<0.001) and in zone 3 (mean −44.18%; p<0.001). Addiitonally, baseline to year 1 in the q12wk group demonstrated significant decline panretinally (mean: −47.7%; p<0.001) and in zone 3 (mean: −59.8%; p<0.001). All zones demonstrated significantly decline from month 6 to year 1 in the q12wk group. Conclusion Therapy with IAI demonstrates significantly reduced panretinal MA counts in PDR at 1 year in both treatment groups. The use of automated platforms to detect and quantify MAs may provide a novel imaging marker for evaluating disease activity and therapeutic impact. Trial registration number NCT02863354.
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