skip to main content
Language:
Search Limited to: Search Limited to: Resource type Show Results with: Show Results with: Search type Index

Enhancing Diabetic Macular Edema Treatment Outcomes: Exploring the ESASO Classification and Structural OCT Biomarkers

Ophthalmology and therapy, 2024-05, Vol.13 (5), p.1383-1398 [Peer Reviewed Journal]

The Author(s) 2024 ;2024. The Author(s). ;ISSN: 2193-8245 ;EISSN: 2193-6528 ;DOI: 10.1007/s40123-024-00925-y ;PMID: 38530567

Full text available

Citations Cited by
  • Title:
    Enhancing Diabetic Macular Edema Treatment Outcomes: Exploring the ESASO Classification and Structural OCT Biomarkers
  • Author: Panozzo, Giacomo ; Cicinelli, Maria V. ; Dalla Mura, Giulia ; Giannarelli, Diana ; Vadalà, Maria ; Bonfiglio, Vincenza ; Bellisario, Giovanni ; Bandello, Francesco
  • Subjects: Anti-VEGF ; Diabetic macular edema ; ESASO classification ; Internal Medicine ; Medicine ; Medicine & Public Health ; OCT Biomarkers ; Ophthalmology ; Optical coherence tomography ; Original Research ; Steroid
  • Is Part Of: Ophthalmology and therapy, 2024-05, Vol.13 (5), p.1383-1398
  • Description: Introduction This study assessed the European School of Advanced Studies in Ophthalmology (ESASO) classification’s prognostic value for diabetic macular edema (DME) in predicting intravitreal therapy outcomes. Methods In this retrospective, multicenter study, patients aged > 50 years with type 1 or 2 diabetes and DME received intravitreal antivascular endothelial growth factor (anti-VEGF) agents (ranibizumab, bevacizumab, and aflibercept) or steroids (dexamethasone). The primary outcome was visual acuity (VA) change post-treatment, termed as functional response, measured 4–6 weeks post-third anti-VEGF or 12–16 weeks post-steroid injection, stratified by initial DME stage. Results Of the 560 eyes studied (62% male, mean age 66.7 years), 31% were classified as stage 1 (early), 50% stage 2 (advanced), 17% stage 3 (severe), and 2% stage 4 (atrophic). Visual acuity (VA; decimal) improved by 0.12–0.15 decimals in stages 1–2 but only 0.03 decimal in stage 3 (all p  < 0.0001) and 0.01 in stage 4 ( p  = 0.38). Even in eyes with low baseline VA ≤ 0.3, improvements were significant only in stages 1 and 2 (0.12 and 0.17 decimals, respectively). Central subfield thickness (CST) improvement was greatest in stage 3 (−229 µm, 37.6%, p  < 0.0001), but uncorrelated with VA gains, unlike stages 1 and 2 (respectively: −142 µm, 27.4%; − 5 µm, 12%; both p  < 0.0001). Stage 4 showed no significant CST change. Baseline disorganization of retinal inner layers and focal damage of the ellipsoid zone/external limiting membrane did not influence VA improvement in stages 1 and 2. Treatment patterns varied, with 61% receiving anti-VEGF and 39% dexamethasone, influenced by DME stage, with no significant differences between therapeutic agents. Conclusion The ESASO classification, which views the retina as a neurovascular unit and integrates multiple biomarkers, surpasses single biomarkers in predicting visual outcomes. Significant functional improvement occurred only in stages 1 and 2, suggesting reversible damage, whereas stages 3 and 4 likely reflect irreversible damage.
  • Publisher: Cheshire: Springer Healthcare
  • Language: English
  • Identifier: ISSN: 2193-8245
    EISSN: 2193-6528
    DOI: 10.1007/s40123-024-00925-y
    PMID: 38530567
  • Source: Geneva Foundation Free Medical Journals at publisher websites
    Springer Open Access
    PubMed Central
    DOAJ Directory of Open Access Journals
Back to results list
INSPIRE LIBRARY - TON DUC THANG UNIVERSITY (84-028) 37 755 057 Feedback
19 Nguyen Huu Tho St. Dist.7, HCM thuvien@tdtu.edu.vn

Copyright © 2017 INSPIRE LIBRARY - TON DUC THANG UNIVERSITY

Searching Remote Databases, Please Wait