Anti-angiogenesis therapy of diabetic macular edema in patients with primary open-angle glaucoma

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PURPOSE

To study the effect of anti-VEGF therapy on the structural and functional state of the retina and optic nerve in patients with DME and POAG.

MATERIAL AND METHODS

The study included 72 patients (132 eyes): the 1^st group — 22 patients (40 eyes) with stage I POAG and DME, the 2^nd group — 25 patients (46 eyes) with DME receiving anti-VEGF therapy. The 3^rd group (control) consisted of 25 patients (46 eyes) with stage I POAG. The observation period lasted 24 months. The average number of injections was 8.48±3.65. The indicators for evaluation were: visual acuity, tonometry, perimetry, optical coherence tomography (OCT) of the optic nerve and macular region.

RESULTS

By the end of the observation period, the increase in IOP in the groups was +0.82 (4.4%), 0.41 (2.4%), 0.65 (3.6%) mm Hg. In the group of comorbid patients, a small-scale increase trend of BCVA was noted: +0.05 (6.6%), a decrease in MD by –2.48 Db (92.1%), an increase in excavation volume by 0.16 (43.2%) mm³, decrease in the area of RA by 0.3 mm² (12.7%). A decrease in retinal nerve fibers layer (RNFL) thickness of 6.55 μm (7.8%), mainly the superior (9.2%), inferior (7.3%) and nasal sectors (7.9%). Loss of GCL+IPL 8.68 μm (12.7%) in the superior (19%), superonasal (20.2%) and inferonasal (20.7%) sectors.

CONCLUSION

The combined course of POAG and DME is accompanied by a decrease in the functional and structural parameters of the retina and optic nerve, and a higher rate of progression of glaucomatous optic neuropathy. Long-term results did not reveal a significant deterioration in the structural parameters of the optic disc and retina against the background of anti-VEGF therapy when comparing the study groups.

Keywords:

anti-angiogenesis therapy

optical coherence tomography

glaucoma progression

diabetes mellitus

Authors:

Fursova A.Zh.

Novosibirsk State Regional Clinical Hospital;
Novosibirsk State Medical University

Gamza Yu.A.

Novosibirsk State Medical University;
Private Healthcare institution Clinical Hospital «RZD-Medicine» Novosibirsk

Derbeneva A.S.

Novosibirsk State Regional Clinical Hospital;
Novosibirsk State Medical University

Vasilyeva M.S.

Novosibirsk State Regional Clinical Hospital

Received:

15.07.2020

Accepted:

24.07.2020

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