Pretreatment Clinical Variables Associated With the Response to Intravitreal Bevacisumab (Avastin) Injection In Patients With Persistent Diabetic Macular Edema
Bibliographic record
Abstract
Background: The purpose of the study is to determine whether the pre-treatment clinical systemic variables and optical coherence tomographic (OCT) findings are associated with the subsequent response to the intravitreal Bevacisumab (IVB) in eyes with diabetic macular edema (DME).Patients and Methods: 38 patients (45 eyes) with refractory diabetic macular edema. ; 16 females, 22 males and mean age was 57.5 year. All patients had DME not responded to other treatments. Complete eye examination; BCVA* (represented as LOGMAR for adequate statistical analysis), slitlamp exam, intraocular pressure measurement, stereoscopic biomicroscopy of the macula, and morphologic patterns of diabetic macular edema demonstrated by OCT. All patients had intravitreal injection of 0.05mL =1.25 mg Bevacizumab (Avastin; Genentech, Inc.,San Francisco, CA), and followed up for 3 months. The pre and post-operative follow-up data were analyzed by Student-t test and Mann-Whitney test for two main outcome measures; visual acuity (LOGMAR) & central foveal thickness (CFT) changes over a period of three months, and data include demographic factors, type, duration and control of diabetes mellitus (HbA1C%), grade of diabetic retinopathy, renal function (serum creatinine level), serum cholesterol, blood pressure control and previous treatment by focal laser and/or intravitreal triamcinolone injection.Results: The visual acuity and CRT improved in 30/45 eyes (67%) and 32/45 eyes (72%) respectively during a mean follow-up time of three months. The mean LogMAR visual acuities were 0.64 (SD ± 0.34), 0.61 (SD ± 0.31) and 0.60 (SD ± 0.32) at pre-injection, at 1 month post-injection and at 3 months post-injection respectively; but this mean increase in vision was statistically not significant (P value = 0.099). The mean foveal thicknesses were 444.95 μ (SD ± 127.36), 394.95 μ (SD ± 138.03) and 378.32 μ (SD ± 112.01) at pre-injection, 1 month post-injection and 3 months post-injection respectively, this decrease in the foveal thickness was statistically significant (P value < 0.001). The LogMAR and CFT values before and after IVB injection showed significant statistical correlations =(p< 0.05) in relationship to variables of diabetic duration, diabetic control (HbA1c), and OCT pattern of macular edema, serum creatinine and cholesterol.Conclusions: chronicity and inadequate control of diabetes mellitus, nephropathy, hyperlipidemia and =presence of vitreomacular attachment (VMA) are factors associated with poor vision progress after intravitreal Bevacisumab injection.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".