Elevated ApoB/A1 ratio predicts enhanced short-term efficacy of anti-VEGF therapy in diabetic macular edema

Abnormalities in lipid metabolism play an important role in diabetic macular edema (DME), and the aim of this study was to investigate the correlation between ApoB/A1 levels and best corrected visual acuity (BCVA) and macular microstructural changes in DME patients after anti-VEGF treatment. Through a retrospective cohort analysis of 61 patients (61 eyes) with non-proliferative diabetic retinopathy combined with macular edema treated with 3 + PRN anti-VEGF regimen and followed up for three months, grouped by median ApoB/A1, the differences between the efficacy indexes of the two groups were compared. The results showed that the macular edema regression rate was significantly higher in the high ApoB/A1 ratio group than in the low ratio group at one month after treatment(P < 0.05), and at three months after treatment, the high ApoB/A1 ratio group was better than the low ratio group in BCVA improvement (58.1% vs. 26.7%), inner retinal layer restoration (38.7% vs. 10.0%), and hyperreflective foci (HF) reduction (41.9% vs. 6.7%). aspects were better than those in the low ratio group (P < 0.05). The results of ordered logistic regression analysis showed that the ApoB/A1 ratio was significantly correlated with the change in macular edema at one month after treatment and the change in the number of HF at three months after treatment. Conclusions showed that the ApoB/A1 ratio was significantly correlated with short-term improvement of BCVA and macular microstructure after anti-VEGF treatment in DME patients, and it is expected to be used as an objective biomarker for assessing the efficacy of anti-VEGF treatment in DME patients.