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Shen L, Zheng Y, Gao Z, Li Q, Dai M, Yang W, Zhang Q, Li D, Hu Y, Yuan L. Efficacy and safety of intravitreal injection of conbercept for moderate to severe nonproliferative diabetic retinopathy. Front Med (Lausanne) 2024; 11:1394358. [PMID: 38846145 PMCID: PMC11153662 DOI: 10.3389/fmed.2024.1394358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2024] [Accepted: 05/10/2024] [Indexed: 06/09/2024] Open
Abstract
Purpose This study aimed to assess the effectiveness and safety of intravitreal injection of conbercept (IVC) in treating moderate to severe nonproliferative diabetic retinopathy (NPDR), with or without accompanying diabetic macular edema. Methods In this longitudinal retrospective study, 35 patients (50 eyes) with moderate to severe NPDR and Diabetic Retinopathy Severity Scale (DRSS) scores between 43 and 53 were treated at the Department of Ophthalmology, First Affiliated Hospital of Kunming Medical University, from October 2018 to January 2023. Treatment protocol included three monthly IVC injections followed by a pro re nata (PRN) regimen over a two-year follow-up period. Outcome measures were best-corrected visual acuity (BCVA), intraocular pressure, central macular thickness (CMT), extent of hard exudate (HE), and changes in DRSS scores. DRSS scores before and after treatment were analyzed using the Wilcoxon rank-sum test. Both systemic and ocular adverse events were meticulously documented to ascertain safety. Results From baseline to the final follow-up, the mean BCVA improved from 0.41 ± 0.39 to 0.23 ± 0.20 logMAR (p<0.05). The mean CMT decreased from 306.22 ± 77.40 to 297.97 ± 88.15 μm (p = 0.385). At 24 months, DRSS scores improved by ≥1 stage in 40 eyes (80%), ≥ 2 stages in 28 eyes (56%), ≥3 stages in 10 eyes (20%), and remained stable in 6 eyes (12%). The DRSS scores at each follow-up interval demonstrated statistically significant improvement from baseline (p<0.05). In 15 of 27 eyes (55.56%) with diabetic macular edema (DME), there was a significant reduction in the mean area of HE from baseline (p<0.05). No serious systemic adverse events were observed. Conclusion IVC is an effective and safe treatment for moderate to severe NPDR, demonstrating significant improvements in DRSS scores.
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Affiliation(s)
- Lu Shen
- Department of Ophthalmology, The First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Yuxiang Zheng
- Department of Ophthalmology, The First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Zelan Gao
- Department of Ophthalmology, Yan’an Hospital of Kunming City, Kunming, China
| | - Qirui Li
- Department of Ophthalmology, The First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Min Dai
- Department of Ophthalmology, The First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Wenchang Yang
- Department of Ophthalmology, The First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Qiying Zhang
- Department of Ophthalmology, The First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Dongli Li
- Department of Ophthalmology, The First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Yijun Hu
- Guangdong Eye Institute, Department of Ophthalmology, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China
| | - Ling Yuan
- Department of Ophthalmology, The First Affiliated Hospital of Kunming Medical University, Kunming, China
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Li J, Li X, Lei M, Li W, Chen W, Ma T, Gao Y, Ye Z, Li Z. A prediction model for worsening diabetic retinopathy after panretinal photocoagulation. Diabetol Metab Syndr 2022; 14:124. [PMID: 36028852 PMCID: PMC9419399 DOI: 10.1186/s13098-022-00892-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Accepted: 08/15/2022] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND As one of the severe complications of diabetes mellitus, diabetic retinopathy (DR) is the leading cause of blindness in the working age worldwide. Although panretinal photocoagulation (PRP) was standard treatment, PRP-treated DR still has a high risk of progression. Hence, this study aimed to assess the risk factors and establish a model for predicting worsening diabetic retinopathy (DR-worsening) within five years after PRP. METHODS Patients who were diagnosed with severe non-proliferative diabetic retinopathy or proliferative diabetic retinopathy and treated with PRP were included, and those patients were randomly assigned to either a training or validation cohort. The multivariate logistic regression analysis was used to screen potential risk factors for DR-worsening in the training cohort. Then the model was established after including significant independent risk factors and further validated using discrimination and calibration. RESULTS A total of 271 patients were included, and 56.46% of patients had an outcome of DR-worsening. In the training cohort (n = 135), age (odds ratio [OR] = 0.94, 95% confidence interval [CI] 0.90-0.98), baseline best corrected visual acuity (logMAR) (OR = 10.74, 95% CI 1.84-62.52), diabetic nephropathy (OR = 9.32, 95% CI 1.49-58.46), and hyperlipidemia (OR = 3.34, 95% CI 1.05-10.66) were screened out as the independent risk factors, which were incorporated into the predictive model. The area under the receiver operating characteristic curve and calibration slope in the training and validation cohort were 0.79, 0.96 (95% CI 0.60-1.31), and 0.79, 1.00 (95% CI 0.66-1.34), respectively. Two risk groups were developed depending on the best cut-off value of the predicted probability, and the actual probability was 34.90% and 82.79% in the low-risk and high-risk groups, respectively (P < 0.001). CONCLUSIONS This study developed and internally validated a new model to predict the probability of DR-worsening after PRP treatment within five years. The model can be used as a rapid risk assessment system for clinical prediction of DR-worsening and identify individuals at a high risk of DR-worsening at an early stage and prescribe additional treatment.
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Affiliation(s)
- Jinglan Li
- Medical School of Chinese PLA, Beijing, China
- Department of Ophthalmology, The First Medical Centre, Chinese PLA General Hospital, 28 Fuxing Road, Haidian District, Beijing, China
| | - Xuanlong Li
- Medical School of Chinese PLA, Beijing, China
- Department of Ophthalmology, The First Medical Centre, Chinese PLA General Hospital, 28 Fuxing Road, Haidian District, Beijing, China
| | | | - Wanyue Li
- Medical School of Chinese PLA, Beijing, China
- Department of Ophthalmology, The First Medical Centre, Chinese PLA General Hospital, 28 Fuxing Road, Haidian District, Beijing, China
| | - Wenqian Chen
- Department of Ophthalmology, The First Medical Centre, Chinese PLA General Hospital, 28 Fuxing Road, Haidian District, Beijing, China
| | - Tianju Ma
- Department of Ophthalmology, The First Medical Centre, Chinese PLA General Hospital, 28 Fuxing Road, Haidian District, Beijing, China
| | - Yi Gao
- Department of Ophthalmology, The First Medical Centre, Chinese PLA General Hospital, 28 Fuxing Road, Haidian District, Beijing, China
| | - Zi Ye
- Department of Ophthalmology, The First Medical Centre, Chinese PLA General Hospital, 28 Fuxing Road, Haidian District, Beijing, China
| | - Zhaohui Li
- Department of Ophthalmology, The First Medical Centre, Chinese PLA General Hospital, 28 Fuxing Road, Haidian District, Beijing, China
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