Alterations in retinal arteriolar microvascular structure associates with higher treatment burden in patients with diabetic macular edema: results from a 12-month prospective clinical trial

Søren Leer Blindbæk, Tunde Peto, Jakob Grauslund

Research output: Contribution to journalArticle

Abstract

Purpose
This study was based on data from a 12‐month prospective clinical trial and aimed to examine changes in retinal microvascular structure in eyes treated with intravitreal aflibercept in combination with focal/grid laser photocoagulation for diabetic macular oedema (DME).

Methods
We included 32 treatment naïve eyes of 22 patients with centre involving DME. The treatment algorithm comprised a loading phase of three monthly injections of aflibercept and focal/grid laser photocoagulation [baseline (BL)‐month 3 (M3)] followed by a pro re nata (PRN) aflibercept phase until month 12 (M12). Eyes were divided into groups with and without need for PRN treatment after loading. Parameters of retinal microvascular structure were measured in 45° optic disc centred fundus images at BL, M3 and M12 using a semi‐automated software (VAMPIRE®, Vessel Assessment and Measurement Platform for Images of the Retina, Universities of Dundee and Edinburgh, UK).

Results
A significant decrease in retinal arteriolar calibre was demonstrated at both M3 (−11.2 μm, p = 0.005) and M12 (−11.5 μm, p = 0.04) as compared to BL in eyes that needed PRN treatment during follow‐up. In contrast, arteriolar calibre remained unchanged in eyes without need for PRN treatment (M3: −1.6 μm, p = 0.79 and M12: −7.0 μm, p = 0.22). For retinal venules, vessel calibre decreased both in eyes with and without need for PRN therapy at M3 (−9.5 μm, p = 0.01 and −11.6 μm, p = 0.01) as well as at M12 (−15.6 μm, p = 0.001 and −11.0 μm, p = 0.04).

Conclusion
Early changes in retinal arteriolar calibre are associated with an increased treatment burden during the first year of DME treatment.
Original languageEnglish
JournalActa Ophthalmologica
Early online date25 Oct 2019
DOIs
Publication statusEarly online date - 25 Oct 2019

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Macular Edema
Clinical Trials
Light Coagulation
Therapeutics
Lasers
Retinal Vessels
Venules
Optic Disk
Retina
Software
Injections

Cite this

@article{8e419ebc6fb942558d6b8f62823e306f,
title = "Alterations in retinal arteriolar microvascular structure associates with higher treatment burden in patients with diabetic macular edema: results from a 12-month prospective clinical trial",
abstract = "PurposeThis study was based on data from a 12‐month prospective clinical trial and aimed to examine changes in retinal microvascular structure in eyes treated with intravitreal aflibercept in combination with focal/grid laser photocoagulation for diabetic macular oedema (DME).MethodsWe included 32 treatment na{\"i}ve eyes of 22 patients with centre involving DME. The treatment algorithm comprised a loading phase of three monthly injections of aflibercept and focal/grid laser photocoagulation [baseline (BL)‐month 3 (M3)] followed by a pro re nata (PRN) aflibercept phase until month 12 (M12). Eyes were divided into groups with and without need for PRN treatment after loading. Parameters of retinal microvascular structure were measured in 45° optic disc centred fundus images at BL, M3 and M12 using a semi‐automated software (VAMPIRE{\circledR}, Vessel Assessment and Measurement Platform for Images of the Retina, Universities of Dundee and Edinburgh, UK).ResultsA significant decrease in retinal arteriolar calibre was demonstrated at both M3 (−11.2 μm, p = 0.005) and M12 (−11.5 μm, p = 0.04) as compared to BL in eyes that needed PRN treatment during follow‐up. In contrast, arteriolar calibre remained unchanged in eyes without need for PRN treatment (M3: −1.6 μm, p = 0.79 and M12: −7.0 μm, p = 0.22). For retinal venules, vessel calibre decreased both in eyes with and without need for PRN therapy at M3 (−9.5 μm, p = 0.01 and −11.6 μm, p = 0.01) as well as at M12 (−15.6 μm, p = 0.001 and −11.0 μm, p = 0.04).ConclusionEarly changes in retinal arteriolar calibre are associated with an increased treatment burden during the first year of DME treatment.",
author = "Blindb{\ae}k, {S{\o}ren Leer} and Tunde Peto and Jakob Grauslund",
year = "2019",
month = "10",
day = "25",
doi = "10.1111/aos.14278",
language = "English",
journal = "Acta Ophthalmologica",
issn = "1755-375X",
publisher = "Wiley-Blackwell",

}

TY - JOUR

T1 - Alterations in retinal arteriolar microvascular structure associates with higher treatment burden in patients with diabetic macular edema: results from a 12-month prospective clinical trial

AU - Blindbæk, Søren Leer

AU - Peto, Tunde

AU - Grauslund, Jakob

PY - 2019/10/25

Y1 - 2019/10/25

N2 - PurposeThis study was based on data from a 12‐month prospective clinical trial and aimed to examine changes in retinal microvascular structure in eyes treated with intravitreal aflibercept in combination with focal/grid laser photocoagulation for diabetic macular oedema (DME).MethodsWe included 32 treatment naïve eyes of 22 patients with centre involving DME. The treatment algorithm comprised a loading phase of three monthly injections of aflibercept and focal/grid laser photocoagulation [baseline (BL)‐month 3 (M3)] followed by a pro re nata (PRN) aflibercept phase until month 12 (M12). Eyes were divided into groups with and without need for PRN treatment after loading. Parameters of retinal microvascular structure were measured in 45° optic disc centred fundus images at BL, M3 and M12 using a semi‐automated software (VAMPIRE®, Vessel Assessment and Measurement Platform for Images of the Retina, Universities of Dundee and Edinburgh, UK).ResultsA significant decrease in retinal arteriolar calibre was demonstrated at both M3 (−11.2 μm, p = 0.005) and M12 (−11.5 μm, p = 0.04) as compared to BL in eyes that needed PRN treatment during follow‐up. In contrast, arteriolar calibre remained unchanged in eyes without need for PRN treatment (M3: −1.6 μm, p = 0.79 and M12: −7.0 μm, p = 0.22). For retinal venules, vessel calibre decreased both in eyes with and without need for PRN therapy at M3 (−9.5 μm, p = 0.01 and −11.6 μm, p = 0.01) as well as at M12 (−15.6 μm, p = 0.001 and −11.0 μm, p = 0.04).ConclusionEarly changes in retinal arteriolar calibre are associated with an increased treatment burden during the first year of DME treatment.

AB - PurposeThis study was based on data from a 12‐month prospective clinical trial and aimed to examine changes in retinal microvascular structure in eyes treated with intravitreal aflibercept in combination with focal/grid laser photocoagulation for diabetic macular oedema (DME).MethodsWe included 32 treatment naïve eyes of 22 patients with centre involving DME. The treatment algorithm comprised a loading phase of three monthly injections of aflibercept and focal/grid laser photocoagulation [baseline (BL)‐month 3 (M3)] followed by a pro re nata (PRN) aflibercept phase until month 12 (M12). Eyes were divided into groups with and without need for PRN treatment after loading. Parameters of retinal microvascular structure were measured in 45° optic disc centred fundus images at BL, M3 and M12 using a semi‐automated software (VAMPIRE®, Vessel Assessment and Measurement Platform for Images of the Retina, Universities of Dundee and Edinburgh, UK).ResultsA significant decrease in retinal arteriolar calibre was demonstrated at both M3 (−11.2 μm, p = 0.005) and M12 (−11.5 μm, p = 0.04) as compared to BL in eyes that needed PRN treatment during follow‐up. In contrast, arteriolar calibre remained unchanged in eyes without need for PRN treatment (M3: −1.6 μm, p = 0.79 and M12: −7.0 μm, p = 0.22). For retinal venules, vessel calibre decreased both in eyes with and without need for PRN therapy at M3 (−9.5 μm, p = 0.01 and −11.6 μm, p = 0.01) as well as at M12 (−15.6 μm, p = 0.001 and −11.0 μm, p = 0.04).ConclusionEarly changes in retinal arteriolar calibre are associated with an increased treatment burden during the first year of DME treatment.

U2 - 10.1111/aos.14278

DO - 10.1111/aos.14278

M3 - Article

JO - Acta Ophthalmologica

JF - Acta Ophthalmologica

SN - 1755-375X

ER -