Prognostic value of neurodegenerative biomarkers in the treatment of diabetic macular edema

Relevance Diabetic macular edema (DME) is the leading cause of visual impairment in patients with diabetes mellitus [1, 3, 6]. Despite the positive effect of anti-VEGF therapy, treatment results remain controversial, which emphasizes the need to search for neurodegenerative biomarkers to predict the response to therapy and optimize treatment regimens [2, 4, 5]. Objective To evaluate the predictive value of neurodegenerative biomarkers for determining the effectiveness of anti-VEGF therapy in patients with DME. Material and methods The study involved 14 patients (20 eyes) diagnosed with DME, distributed by type of diabetes mellitus. The best-corrected visual acuity (BCVA), central retinal thickness (CRT), nerve fiber layer thickness and ganglion cell layer complex, and the integrity of the ellipsoidal zone were assessed. All patients received a course of 5 intravitreal injections of Aflibercept. Results After treatment, statistically significant increase in BCVA and decrease in CTS were observed. Correlation analysis revealed a link between functional improvements and reduction in neurodegenerative changes. The results confirm the effectiveness of Aflibercept therapy and demonstrate the potential of using these neurodegenerative biomarkers to predict the response to DME treatment. Keywords: biomarkers; diabetic macular edema; diabetic retinopathy; anti-VEGF therapy