Predictive Role of Complete Blood Count-Derived Inflammation Indices and Optical Coherence Tomography Biomarkers for Early Response to Intravitreal Anti-VEGF in Diabetic Macular Edema
<b>Background:</b> Diabetic macular edema (DME) is the leading cause of vision impairment in diabetic patients, with intravitreal anti-vascular endothelial growth factor (anti-VEGF) injections being the first-line therapy. However, one-third of patients exhibit persistent DME despite tre...
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2025-05-01
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| author | Ece Ergin Ana Maria Dascalu Daniela Stana Laura Carina Tribus Andreea Letitia Arsene Marina Ionela Nedea Dragos Serban Claudiu Eduard Nistor Corneliu Tudor Dan Dumitrescu Paul Lorin Stoica Bogdan Mihai Cristea |
| author_facet | Ece Ergin Ana Maria Dascalu Daniela Stana Laura Carina Tribus Andreea Letitia Arsene Marina Ionela Nedea Dragos Serban Claudiu Eduard Nistor Corneliu Tudor Dan Dumitrescu Paul Lorin Stoica Bogdan Mihai Cristea |
| author_sort | Ece Ergin |
| collection | DOAJ |
| description | <b>Background:</b> Diabetic macular edema (DME) is the leading cause of vision impairment in diabetic patients, with intravitreal anti-vascular endothelial growth factor (anti-VEGF) injections being the first-line therapy. However, one-third of patients exhibit persistent DME despite treatment, suggesting additional pathogenic factors. This study aimed to evaluate the predictive value of complete blood count (CBC)-based inflammation indexes and optical coherence tomography (OCT) parameters in determining early anti-VEGF treatment effectiveness in DME. <b>Methods:</b> One hundred and four naïve patients with DME, treated with 0.05 mL of intravitreal aflibercept were retrospectively analyzed. Blood parameters analyzed included neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), platelet-to-lymphocyte ratio (PLR), and systemic immune-inflammation index (SII). Baseline OCT biomarkers included subretinal fluid (SRF), intraretinal cysts (IRC), hyperreflective retinal spots (HRS), and disorganization of retinal inner layers (DRIL). Treatment response was defined as a minimum 10% reduction in central macular thickness (CMT) at one month post-injection. <b>Results:</b> NLR, MLR, PLR, and SII were significantly higher in non-responders (<i>p</i> < 0.001), but their predictive value was fair, with an area under the ROC curve ranging between 0.704 (MLR) and 0.788 (SII). A multivariate model including SII, initial CMT, and the presence of IRC showed an excellent prediction value for early anatomical response (AUC ROC of 0.911). At the same time, lower PLR, DRIL, SRF, and the absence of HRF were correlated with early gain in BCVA. <b>Conclusions:</b> CBC-derived inflammation indices and OCT biomarkers have prognostic value in predicting early response to anti-VEGF therapy in DME in terms of functional and anatomical outcomes. These findings could help identify poor responders and guide personalized treatment strategies. |
| format | Article |
| id | doaj-art-7a32c05991b04804968df2016e50b498 |
| institution | Kabale University |
| issn | 2227-9059 |
| language | English |
| publishDate | 2025-05-01 |
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| series | Biomedicines |
| spelling | doaj-art-7a32c05991b04804968df2016e50b4982025-08-20T03:27:05ZengMDPI AGBiomedicines2227-90592025-05-01136130810.3390/biomedicines13061308Predictive Role of Complete Blood Count-Derived Inflammation Indices and Optical Coherence Tomography Biomarkers for Early Response to Intravitreal Anti-VEGF in Diabetic Macular EdemaEce Ergin0Ana Maria Dascalu1Daniela Stana2Laura Carina Tribus3Andreea Letitia Arsene4Marina Ionela Nedea5Dragos Serban6Claudiu Eduard Nistor7Corneliu Tudor8Dan Dumitrescu9Paul Lorin Stoica10Bogdan Mihai Cristea11Doctoral School, “Carol Davila” University of Medicine and Pharmacy Bucharest, 020021 Bucharest, RomaniaDoctoral School, “Carol Davila” University of Medicine and Pharmacy Bucharest, 020021 Bucharest, RomaniaOphthalmology Department, Emergency University Hospital Bucharest, 050098 Bucharest, RomaniaFaculty of Dental Medicine, “Carol Davila” University of Medicine and Pharmacy Bucharest, 020021 Bucharest, RomaniaFaculty of Pharmacy, “Carol Davila” University of Medicine and Pharmacy Bucharest, 020021 Bucharest, RomaniaFaculty of Pharmacy, “Carol Davila” University of Medicine and Pharmacy Bucharest, 020021 Bucharest, RomaniaDoctoral School, “Carol Davila” University of Medicine and Pharmacy Bucharest, 020021 Bucharest, RomaniaDoctoral School, “Carol Davila” University of Medicine and Pharmacy Bucharest, 020021 Bucharest, RomaniaFaculty of Medicine, “Carol Davila” University of Medicine and Pharmacy Bucharest, 020021 Bucharest, RomaniaFaculty of Medicine, “Carol Davila” University of Medicine and Pharmacy Bucharest, 020021 Bucharest, RomaniaFaculty of Medicine, “Carol Davila” University of Medicine and Pharmacy Bucharest, 020021 Bucharest, RomaniaFaculty of Medicine, “Carol Davila” University of Medicine and Pharmacy Bucharest, 020021 Bucharest, Romania<b>Background:</b> Diabetic macular edema (DME) is the leading cause of vision impairment in diabetic patients, with intravitreal anti-vascular endothelial growth factor (anti-VEGF) injections being the first-line therapy. However, one-third of patients exhibit persistent DME despite treatment, suggesting additional pathogenic factors. This study aimed to evaluate the predictive value of complete blood count (CBC)-based inflammation indexes and optical coherence tomography (OCT) parameters in determining early anti-VEGF treatment effectiveness in DME. <b>Methods:</b> One hundred and four naïve patients with DME, treated with 0.05 mL of intravitreal aflibercept were retrospectively analyzed. Blood parameters analyzed included neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), platelet-to-lymphocyte ratio (PLR), and systemic immune-inflammation index (SII). Baseline OCT biomarkers included subretinal fluid (SRF), intraretinal cysts (IRC), hyperreflective retinal spots (HRS), and disorganization of retinal inner layers (DRIL). Treatment response was defined as a minimum 10% reduction in central macular thickness (CMT) at one month post-injection. <b>Results:</b> NLR, MLR, PLR, and SII were significantly higher in non-responders (<i>p</i> < 0.001), but their predictive value was fair, with an area under the ROC curve ranging between 0.704 (MLR) and 0.788 (SII). A multivariate model including SII, initial CMT, and the presence of IRC showed an excellent prediction value for early anatomical response (AUC ROC of 0.911). At the same time, lower PLR, DRIL, SRF, and the absence of HRF were correlated with early gain in BCVA. <b>Conclusions:</b> CBC-derived inflammation indices and OCT biomarkers have prognostic value in predicting early response to anti-VEGF therapy in DME in terms of functional and anatomical outcomes. These findings could help identify poor responders and guide personalized treatment strategies.https://www.mdpi.com/2227-9059/13/6/1308diabetic macular edemaintravitreal anti-VEGFneutrophil-to-lymphocyte ratiosystemic inflammation indexplatelet-to-lymphocyte ratioOCT biomarkers |
| spellingShingle | Ece Ergin Ana Maria Dascalu Daniela Stana Laura Carina Tribus Andreea Letitia Arsene Marina Ionela Nedea Dragos Serban Claudiu Eduard Nistor Corneliu Tudor Dan Dumitrescu Paul Lorin Stoica Bogdan Mihai Cristea Predictive Role of Complete Blood Count-Derived Inflammation Indices and Optical Coherence Tomography Biomarkers for Early Response to Intravitreal Anti-VEGF in Diabetic Macular Edema Biomedicines diabetic macular edema intravitreal anti-VEGF neutrophil-to-lymphocyte ratio systemic inflammation index platelet-to-lymphocyte ratio OCT biomarkers |
| title | Predictive Role of Complete Blood Count-Derived Inflammation Indices and Optical Coherence Tomography Biomarkers for Early Response to Intravitreal Anti-VEGF in Diabetic Macular Edema |
| title_full | Predictive Role of Complete Blood Count-Derived Inflammation Indices and Optical Coherence Tomography Biomarkers for Early Response to Intravitreal Anti-VEGF in Diabetic Macular Edema |
| title_fullStr | Predictive Role of Complete Blood Count-Derived Inflammation Indices and Optical Coherence Tomography Biomarkers for Early Response to Intravitreal Anti-VEGF in Diabetic Macular Edema |
| title_full_unstemmed | Predictive Role of Complete Blood Count-Derived Inflammation Indices and Optical Coherence Tomography Biomarkers for Early Response to Intravitreal Anti-VEGF in Diabetic Macular Edema |
| title_short | Predictive Role of Complete Blood Count-Derived Inflammation Indices and Optical Coherence Tomography Biomarkers for Early Response to Intravitreal Anti-VEGF in Diabetic Macular Edema |
| title_sort | predictive role of complete blood count derived inflammation indices and optical coherence tomography biomarkers for early response to intravitreal anti vegf in diabetic macular edema |
| topic | diabetic macular edema intravitreal anti-VEGF neutrophil-to-lymphocyte ratio systemic inflammation index platelet-to-lymphocyte ratio OCT biomarkers |
| url | https://www.mdpi.com/2227-9059/13/6/1308 |
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