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The area of fixation covaries with short‐term changes in visual acuity after anti‐vascular endothelial growth factor treatment in patients with diabetic macular oedema
Purpose Diabetic maculopathy can be treated with intravitreal injection of vascular endothelial growth factor (VEGF) inhibitors. However, the therapy is not effective in all patients, and it would be desirable to have parameters for differentiating patients who will benefit from treatment from those...
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| Published in: | Acta ophthalmologica (Oxford, England) England), 2018-11, Vol.96 (7), p.744-748 |
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| container_title | Acta ophthalmologica (Oxford, England) |
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| creator | Jakobsen, Nanna Stæhr Larsen, Dorte Ancher Bek, Toke |
| description | Purpose
Diabetic maculopathy can be treated with intravitreal injection of vascular endothelial growth factor (VEGF) inhibitors. However, the therapy is not effective in all patients, and it would be desirable to have parameters for differentiating patients who will benefit from treatment from those who will not. Retinal fixation has been shown to be impaired in patients with low visual acuity (VA) secondary to macular disease, but the changes in fixational eye movements after anti‐VEGF treatment for diabetic maculopathy have not been investigated.
Methods
Retinal fixation was studied in 29 patients with diabetic macular oedema before three monthly anti‐VEGF injections, and 1 and 4 months after the last injection. The change in VA was correlated with changes in area, frequency, amplitude and total number of fixational saccades.
Results
During three monthly injections, best‐corrected visual acuity (BCVA) increased from (mean ± SD) 74.0 ± 11.5 Early Treatment Diabetic Retinopathy Study (ETDRS) letters to 78.3 ± 9.8 ETDRS letters, (p = 0.003) and central retinal thickness (CRT) decreased from (mean ± SD) 441.7 ± 107.0 μm to 339.5 ± 74.2 μm, (p = |
| doi_str_mv | 10.1111/aos.13773 |
| format | article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2031028330</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2031028330</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3603-eb5e36944396db4f3d9bf3b1f046c778ea163f6ba18aafe8b16a75b7de47e5b13</originalsourceid><addsrcrecordid>eNp1kc9O3DAQh62KqlDaQ18A-UgPC_Y6sZMjQvSPhMQBkLhFY2dMXCXxYju77K2P0PfoW_VJ6m0Wbp3LjDSfvt_hR8gnzs54nnPw8YwLpcQbcsRVWS6EktXB610-HJL3Mf5gTHIpi3fkcFnLSpV1eUR-33VIISBQb6l1z5CcH6nxawgOI9241NHY-ZD-_PyVMAzUdDA-5o8b6drFCXoKZnJpS8HmP4UxuYyuIZqph0BxbH3qsHcZfAx-k3UWTPKBphyaBhzTTrXKufncB7YONCZn6ACzxWOLA3wgby30ET_u9zG5_3J1d_ltcX3z9fvlxfXCCMnEAnWJQtZFIWrZ6sKKttZWaG5ZIY1SFQKXwkoNvAKwWGkuQZVatVgoLDUXx-R09q6Cf5owpmZw0WDfw4h-is2SCc6WlRAso59n1AQfY0DbrIIbIGwbzppdN03upvnXTWZP9tpJD9i-ki9lZOB8Bjaux-3_Tc3Fze2s_AtQxp_j</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2031028330</pqid></control><display><type>article</type><title>The area of fixation covaries with short‐term changes in visual acuity after anti‐vascular endothelial growth factor treatment in patients with diabetic macular oedema</title><source>Wiley</source><creator>Jakobsen, Nanna Stæhr ; Larsen, Dorte Ancher ; Bek, Toke</creator><creatorcontrib>Jakobsen, Nanna Stæhr ; Larsen, Dorte Ancher ; Bek, Toke</creatorcontrib><description>Purpose
Diabetic maculopathy can be treated with intravitreal injection of vascular endothelial growth factor (VEGF) inhibitors. However, the therapy is not effective in all patients, and it would be desirable to have parameters for differentiating patients who will benefit from treatment from those who will not. Retinal fixation has been shown to be impaired in patients with low visual acuity (VA) secondary to macular disease, but the changes in fixational eye movements after anti‐VEGF treatment for diabetic maculopathy have not been investigated.
Methods
Retinal fixation was studied in 29 patients with diabetic macular oedema before three monthly anti‐VEGF injections, and 1 and 4 months after the last injection. The change in VA was correlated with changes in area, frequency, amplitude and total number of fixational saccades.
Results
During three monthly injections, best‐corrected visual acuity (BCVA) increased from (mean ± SD) 74.0 ± 11.5 Early Treatment Diabetic Retinopathy Study (ETDRS) letters to 78.3 ± 9.8 ETDRS letters, (p = 0.003) and central retinal thickness (CRT) decreased from (mean ± SD) 441.7 ± 107.0 μm to 339.5 ± 74.2 μm, (p = <0.0001), which was followed by the opposite changes after treatment (BCVA reduced nonsignificantly to 77.5 ± 10.4 ETDRS letters (p = 0.06), and CRT increased to 393.0 ± 9.8 μm, p = <0.0001). Both improvement and worsening of BCVA correlated with the fixation area (r2 = 0.28, p = 0.003 and r2 = 0.14, p = 0.045, respectively), but only improvement of BCVA correlated with the frequency (r2 = 0.15, p = 0.037) and total number of saccades (r2 = 0.18, p = 0.02). BCVA showed no correlation with the amplitude and most frequently occurring saccade amplitude.
Conclusion
Fixational eye movements may be used to monitor short‐term effects of anti‐VEGF treatment on diabetic macular oedema. Future studies should aim at investigating a possible predictive value of fixational eye movements for visual function in the long term.</description><identifier>ISSN: 1755-375X</identifier><identifier>EISSN: 1755-3768</identifier><identifier>DOI: 10.1111/aos.13773</identifier><identifier>PMID: 29687595</identifier><language>eng</language><publisher>England</publisher><subject>Angiogenesis Inhibitors - therapeutic use ; anti‐VEGF treatment ; Bevacizumab - therapeutic use ; diabetic retinopathy ; Diabetic Retinopathy - drug therapy ; Diabetic Retinopathy - physiopathology ; Female ; Fixation, Ocular - physiology ; Follow-Up Studies ; Humans ; Intravitreal Injections ; Macular Edema - drug therapy ; Macular Edema - physiopathology ; macular oedema ; Male ; Middle Aged ; Prospective Studies ; Ranibizumab - therapeutic use ; retinal fixation ; Saccades - physiology ; Vascular Endothelial Growth Factor A - antagonists & inhibitors ; visual acuity ; Visual Acuity - physiology</subject><ispartof>Acta ophthalmologica (Oxford, England), 2018-11, Vol.96 (7), p.744-748</ispartof><rights>2018 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd</rights><rights>2018 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3603-eb5e36944396db4f3d9bf3b1f046c778ea163f6ba18aafe8b16a75b7de47e5b13</citedby><cites>FETCH-LOGICAL-c3603-eb5e36944396db4f3d9bf3b1f046c778ea163f6ba18aafe8b16a75b7de47e5b13</cites><orcidid>0000-0002-1076-9855 ; 0000-0002-0409-2534</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29687595$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Jakobsen, Nanna Stæhr</creatorcontrib><creatorcontrib>Larsen, Dorte Ancher</creatorcontrib><creatorcontrib>Bek, Toke</creatorcontrib><title>The area of fixation covaries with short‐term changes in visual acuity after anti‐vascular endothelial growth factor treatment in patients with diabetic macular oedema</title><title>Acta ophthalmologica (Oxford, England)</title><addtitle>Acta Ophthalmol</addtitle><description>Purpose
Diabetic maculopathy can be treated with intravitreal injection of vascular endothelial growth factor (VEGF) inhibitors. However, the therapy is not effective in all patients, and it would be desirable to have parameters for differentiating patients who will benefit from treatment from those who will not. Retinal fixation has been shown to be impaired in patients with low visual acuity (VA) secondary to macular disease, but the changes in fixational eye movements after anti‐VEGF treatment for diabetic maculopathy have not been investigated.
Methods
Retinal fixation was studied in 29 patients with diabetic macular oedema before three monthly anti‐VEGF injections, and 1 and 4 months after the last injection. The change in VA was correlated with changes in area, frequency, amplitude and total number of fixational saccades.
Results
During three monthly injections, best‐corrected visual acuity (BCVA) increased from (mean ± SD) 74.0 ± 11.5 Early Treatment Diabetic Retinopathy Study (ETDRS) letters to 78.3 ± 9.8 ETDRS letters, (p = 0.003) and central retinal thickness (CRT) decreased from (mean ± SD) 441.7 ± 107.0 μm to 339.5 ± 74.2 μm, (p = <0.0001), which was followed by the opposite changes after treatment (BCVA reduced nonsignificantly to 77.5 ± 10.4 ETDRS letters (p = 0.06), and CRT increased to 393.0 ± 9.8 μm, p = <0.0001). Both improvement and worsening of BCVA correlated with the fixation area (r2 = 0.28, p = 0.003 and r2 = 0.14, p = 0.045, respectively), but only improvement of BCVA correlated with the frequency (r2 = 0.15, p = 0.037) and total number of saccades (r2 = 0.18, p = 0.02). BCVA showed no correlation with the amplitude and most frequently occurring saccade amplitude.
Conclusion
Fixational eye movements may be used to monitor short‐term effects of anti‐VEGF treatment on diabetic macular oedema. Future studies should aim at investigating a possible predictive value of fixational eye movements for visual function in the long term.</description><subject>Angiogenesis Inhibitors - therapeutic use</subject><subject>anti‐VEGF treatment</subject><subject>Bevacizumab - therapeutic use</subject><subject>diabetic retinopathy</subject><subject>Diabetic Retinopathy - drug therapy</subject><subject>Diabetic Retinopathy - physiopathology</subject><subject>Female</subject><subject>Fixation, Ocular - physiology</subject><subject>Follow-Up Studies</subject><subject>Humans</subject><subject>Intravitreal Injections</subject><subject>Macular Edema - drug therapy</subject><subject>Macular Edema - physiopathology</subject><subject>macular oedema</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Prospective Studies</subject><subject>Ranibizumab - therapeutic use</subject><subject>retinal fixation</subject><subject>Saccades - physiology</subject><subject>Vascular Endothelial Growth Factor A - antagonists & inhibitors</subject><subject>visual acuity</subject><subject>Visual Acuity - physiology</subject><issn>1755-375X</issn><issn>1755-3768</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><recordid>eNp1kc9O3DAQh62KqlDaQ18A-UgPC_Y6sZMjQvSPhMQBkLhFY2dMXCXxYju77K2P0PfoW_VJ6m0Wbp3LjDSfvt_hR8gnzs54nnPw8YwLpcQbcsRVWS6EktXB610-HJL3Mf5gTHIpi3fkcFnLSpV1eUR-33VIISBQb6l1z5CcH6nxawgOI9241NHY-ZD-_PyVMAzUdDA-5o8b6drFCXoKZnJpS8HmP4UxuYyuIZqph0BxbH3qsHcZfAx-k3UWTPKBphyaBhzTTrXKufncB7YONCZn6ACzxWOLA3wgby30ET_u9zG5_3J1d_ltcX3z9fvlxfXCCMnEAnWJQtZFIWrZ6sKKttZWaG5ZIY1SFQKXwkoNvAKwWGkuQZVatVgoLDUXx-R09q6Cf5owpmZw0WDfw4h-is2SCc6WlRAso59n1AQfY0DbrIIbIGwbzppdN03upvnXTWZP9tpJD9i-ki9lZOB8Bjaux-3_Tc3Fze2s_AtQxp_j</recordid><startdate>201811</startdate><enddate>201811</enddate><creator>Jakobsen, Nanna Stæhr</creator><creator>Larsen, Dorte Ancher</creator><creator>Bek, Toke</creator><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-1076-9855</orcidid><orcidid>https://orcid.org/0000-0002-0409-2534</orcidid></search><sort><creationdate>201811</creationdate><title>The area of fixation covaries with short‐term changes in visual acuity after anti‐vascular endothelial growth factor treatment in patients with diabetic macular oedema</title><author>Jakobsen, Nanna Stæhr ; Larsen, Dorte Ancher ; Bek, Toke</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3603-eb5e36944396db4f3d9bf3b1f046c778ea163f6ba18aafe8b16a75b7de47e5b13</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Angiogenesis Inhibitors - therapeutic use</topic><topic>anti‐VEGF treatment</topic><topic>Bevacizumab - therapeutic use</topic><topic>diabetic retinopathy</topic><topic>Diabetic Retinopathy - drug therapy</topic><topic>Diabetic Retinopathy - physiopathology</topic><topic>Female</topic><topic>Fixation, Ocular - physiology</topic><topic>Follow-Up Studies</topic><topic>Humans</topic><topic>Intravitreal Injections</topic><topic>Macular Edema - drug therapy</topic><topic>Macular Edema - physiopathology</topic><topic>macular oedema</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Prospective Studies</topic><topic>Ranibizumab - therapeutic use</topic><topic>retinal fixation</topic><topic>Saccades - physiology</topic><topic>Vascular Endothelial Growth Factor A - antagonists & inhibitors</topic><topic>visual acuity</topic><topic>Visual Acuity - physiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Jakobsen, Nanna Stæhr</creatorcontrib><creatorcontrib>Larsen, Dorte Ancher</creatorcontrib><creatorcontrib>Bek, Toke</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Acta ophthalmologica (Oxford, England)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Jakobsen, Nanna Stæhr</au><au>Larsen, Dorte Ancher</au><au>Bek, Toke</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The area of fixation covaries with short‐term changes in visual acuity after anti‐vascular endothelial growth factor treatment in patients with diabetic macular oedema</atitle><jtitle>Acta ophthalmologica (Oxford, England)</jtitle><addtitle>Acta Ophthalmol</addtitle><date>2018-11</date><risdate>2018</risdate><volume>96</volume><issue>7</issue><spage>744</spage><epage>748</epage><pages>744-748</pages><issn>1755-375X</issn><eissn>1755-3768</eissn><abstract>Purpose
Diabetic maculopathy can be treated with intravitreal injection of vascular endothelial growth factor (VEGF) inhibitors. However, the therapy is not effective in all patients, and it would be desirable to have parameters for differentiating patients who will benefit from treatment from those who will not. Retinal fixation has been shown to be impaired in patients with low visual acuity (VA) secondary to macular disease, but the changes in fixational eye movements after anti‐VEGF treatment for diabetic maculopathy have not been investigated.
Methods
Retinal fixation was studied in 29 patients with diabetic macular oedema before three monthly anti‐VEGF injections, and 1 and 4 months after the last injection. The change in VA was correlated with changes in area, frequency, amplitude and total number of fixational saccades.
Results
During three monthly injections, best‐corrected visual acuity (BCVA) increased from (mean ± SD) 74.0 ± 11.5 Early Treatment Diabetic Retinopathy Study (ETDRS) letters to 78.3 ± 9.8 ETDRS letters, (p = 0.003) and central retinal thickness (CRT) decreased from (mean ± SD) 441.7 ± 107.0 μm to 339.5 ± 74.2 μm, (p = <0.0001), which was followed by the opposite changes after treatment (BCVA reduced nonsignificantly to 77.5 ± 10.4 ETDRS letters (p = 0.06), and CRT increased to 393.0 ± 9.8 μm, p = <0.0001). Both improvement and worsening of BCVA correlated with the fixation area (r2 = 0.28, p = 0.003 and r2 = 0.14, p = 0.045, respectively), but only improvement of BCVA correlated with the frequency (r2 = 0.15, p = 0.037) and total number of saccades (r2 = 0.18, p = 0.02). BCVA showed no correlation with the amplitude and most frequently occurring saccade amplitude.
Conclusion
Fixational eye movements may be used to monitor short‐term effects of anti‐VEGF treatment on diabetic macular oedema. Future studies should aim at investigating a possible predictive value of fixational eye movements for visual function in the long term.</abstract><cop>England</cop><pmid>29687595</pmid><doi>10.1111/aos.13773</doi><tpages>5</tpages><orcidid>https://orcid.org/0000-0002-1076-9855</orcidid><orcidid>https://orcid.org/0000-0002-0409-2534</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Angiogenesis Inhibitors - therapeutic use anti‐VEGF treatment Bevacizumab - therapeutic use diabetic retinopathy Diabetic Retinopathy - drug therapy Diabetic Retinopathy - physiopathology Female Fixation, Ocular - physiology Follow-Up Studies Humans Intravitreal Injections Macular Edema - drug therapy Macular Edema - physiopathology macular oedema Male Middle Aged Prospective Studies Ranibizumab - therapeutic use retinal fixation Saccades - physiology Vascular Endothelial Growth Factor A - antagonists & inhibitors visual acuity Visual Acuity - physiology |
| title | The area of fixation covaries with short‐term changes in visual acuity after anti‐vascular endothelial growth factor treatment in patients with diabetic macular oedema |
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