Predicting DME recurrence following surgical treatment for diabetic maculopathy in a Ukrainian population of patients with type 2 diabetes mellitus
Iu. O. Panchenko 1, S.Yu. Mogilevskyy 2, S.O. Rykov 2, D.G. Zhaboiedov 1,
M.M. Umanets 3, S.V. Ziablitsev 1
1 Bogomolets National Medical University; Kyiv (Ukraine)
2 Shupyk National Healthcare University of Ukraine; Kyiv (Ukraine)
3 SI "The Filatov Institute of Eye Diseases and Tissue Therapy of the NMAS of Ukraine"; Odesa (Ukraine)
Background: Recurrent diabetic maculopathy (DMP) and diabetic macular edema (DME) may develop in the early or late period even after an advanced vitreoretinal procedure. It has been reported that the recurrence rate at one month and at one year after vitreoretinal surgery varied from 6.6% to 20.8% and from 20.8% to 83.3%, respectively.
Purpose: To develop a model for predicting recurrence of DME after surgical treatment for DMP in the Ukrainian population of patients with type 2 diabetes mellitus (T2DM).
Material and Methods: The study included 313 patients with T2DM (313 eyes) who underwent various types of vitreoretinal surgery. Preoperatively, enzyme-linked immunosorbent assays were used to determine blood PDGF-BB, TNFα and ЕТ1 levels, and polymorphisms of PDGFB (rs1800818) and TNFα (rs1800629) were investigated by real-time polymerase chain reaction. At months 1, 3, 6 and 12 after surgery, incidence of DME recurrence and associations of DME recurrence with the characteristics under study were assessed. Multivariate logistic regression analysis was used to develop a model in Statistica 10 (GLZ; StatSoft, Tulsa, OK, USA).
Results: Index of diabetic macular edema progression (DMEI) was used as the dependent variable and calculated as the mean speed of change in central retinal thickness (CRT) over a year after the initiation of treatment for DMP. SNP rs1800818 in PDGFB, SNP rs1800629 in TNFα, blood PDGF-BB level, and CRT0 were found to be significant predictors of the risk for postoperative DME recurrence. The calculation of DMEI values allowed to divide possible genotype combinations into three groups: those promoting the regression (СС-GG; CC-GA; TC-GG), those with a stable DMEI value (TC-GA and TC-AA), and those promoting the progression of DME.
Conclusion: The prediction of DME recurrence after various types of vitreoretinal surgery combined with other methods of surgical treatment for DMP in a Ukrainian population of patients with T2DM is based on the determination of gene polymorphisms of PDGFB and TNFα.
Keywords: diabetic macular edema, surgical treatment, recurrences, recurrences, rs1800629, rs1800818, PDGF-ВВ, TNFα, type 2 diabetes mellitus
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Conflict of Interest Statement:
The authors declare no conflict of interest which could influence their opinions on the subject or the materials presented in the manuscript.