Abstract:AIM: To explore the value of optical coherence tomography(OCT)imaging features in predicting the prognosis of intravitreal injection of conbercept in the treatment of diabetic macular edema(DME).
METHODS: A retrospective selection was made of patients with DME who underwent intravitreal injection of conbercept at the hospital from July 2021 to August 2024. All patients received intravitreal injection of conbercept once a month for a total of 3 mo. OCT and best corrected visual acuity(BCVA)examinations were conducted at 4 mo after the treatment. The change in BCVA at 4 mo post-treatment served as the primary efficacy evaluation metric, with patients achieving a 2-line or greater improvement classified into the favorable prognosis group, while those with less than a 2-line improvement were categorized into the unfavorable prognosis group. Clinical data and OCT-related imaging features of the two groups were collected, and the factors influencing the unfavorable prognosis of patients treated with conbercept for DME and the predictive value of OCT-related imaging features for treatment efficacy were analyzed.
RESULTS:A total of 115 DME patients(115 eyes)were included in this study \〖for patients with bilateral DME, only the eye with greater central macular thickness(CMT)was included\〗. After 4 mo of treatment, 78 cases(78 eyes)were in the good prognosis group, including 45 males and 33 females, with an average age of 60.57±7.46 y. There were 37 cases(37 eyes)in the poor prognosis group, including 24 males and 13 females, with an average age of 59.36±8.72 y. The poor prognosis rate was 32.2%. The BCVA and CMT before treatment in the poor prognosis group were higher than those in the good prognosis group(all P<0.05). The proportions of ELM integrity destruction, EZ integrity destruction, and retinal inner layer structure disorder in the poor prognosis group were all higher than those in the good prognosis group(all P<0.05). The factors influencing the prognosis of DME patients treated with conbercept were pre-treatment CMT(OR=1.030, P<0.001), ELM integrity destruction(OR=22.475, P=0.002), EZ integrity destruction(OR=23.584, P=0.001), and retinal inner layer structure disorder(OR=7.901, P=0.016). The AUC values for predicting poor prognosis of DME patients treated with conbercept by each of the indicators of ELM integrity destruction, EZ integrity destruction, and retinal inner layer structure disorder alone and in combination were 0.699, 0.653, 0.637, and 0.843, respectively.
CONCLUSION: Clinically, OCT examination should be emphasized in patients with DME. In the early stage, by identifying high-risk imaging features, the prognosis of DME patients can be evaluated, providing objective evidence for the formulation of individualized treatment plans.
