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Abstract
Objective Given the increasing burden of repetitive intravitreal injections in diabetic macular oedema (DMO) treatment, non-invasive markers of treatment outcome are needed. Hence, we aimed to examine retinal oximetry parameters as markers of need for intravitreal aflibercept in patients with DMO.
Methods This study was based on data from a 12-month clinical trial including 35 eyes of 25 patients with centre involving DMO. Retinal oximetry, visual acuity (VA) and central retinal thickness (CRT) were performed at baseline (BL). Patients then received 3 monthly injections of aflibercept followed by focal/grid laser photocoagulation. From month 4 (M4) through 12 (M12), patients were followed monthly and additional injections were given pro re nata if criteria of retreatment were met. We evaluated the difference in need for intravitreal aflibercept in groups of eyes with the highest and lowest retinal arteriolar and venular oxygen saturations, respectively.
Results From BL-M12, overall VA letter score improved by 8.7 (7.2–10.2). Likewise CRT reduced by 100.7 (68.2–133.3) µm and the mean number of injections was 4.3 (3.8–4.8). Overall retinal arteriolar and venular oxygen saturations were 95.7 (93.0–98.4)% and 62.7 (59.4–65.9)% at BL. Eyes with the highest retinal arteriolar oxygen saturations had significantly more injections between BL and M12 compared with eyes with the lowest retinal arteriolar oxygen saturations (5.0 (4.2–5.8) vs 3.6 (3.1–4.0), p=0.002).
Conclusion Higher retinal arteriolar oxygen saturation independently predicted the need for more intravitreal aflibercept during the first year of DMO treatment and may serve as a valuable adjunctive to established procedures for retinal imaging in terms of individualised treatment plans.
Trial registration number NCT02554747
- imaging
- macula
- retina
- treatment lasers
- treatment medical
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Footnotes
Contributors All authors contributed equally to the research design and manuscript preparation. Data acquisition/research execution and data analysis were carried out by SLB and JG. SLB and JG had full access to all the data in the study and all authors take responsibility for the integrity of the data and the accuracy of the data analysis.
Funding SLB reports grants from the University of Southern Denmark, grants from Odense University Hospital, grants from Fight for Sight Denmark, grants from The Synoptik Foundation and grants from The Danish Diabetes Academy supported by the Novo Nordisk Foundation, during the conduct of the study.
Competing interests SLB reports no competing interests. TP reports personal fees from Novartis, personal fees from Bayer, personal fees from OPTOS, personal fees from Heidelberg, outside the submitted work. JG reports personal fees from Bayer, personal fees from Novartis, outside the submitted work.
Patient consent for publication Not required.
Ethics approval This study was carried out in accordance with the tenets of the Declaration of Helsinki and Good clinical practice. Ethical approval was obtained from the Regional Scientific Ethical Committee for Southern Denmark (ID: S-20150077).
Provenance and peer review Not commissioned; externally peer reviewed.
Data availability statement Data are available upon request.