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. 2022 Apr 10;12(4):608.
doi: 10.3390/jpm12040608.

Predictive Assessment of Quantitative Ultra-Widefield Angiographic Features for Future Need for Anti-VEGF Therapy in Diabetic Eye Disease

Alice C Jiang  1   2 , Duriye Damla Sevgi  1 , Christopher Mugnaini  1 , Jon Whitney  1 , Sunil K Srivastava  1   3 , Katherine E Talcott  1   3 , Ming Hu  1   4 , Jamie L Reese  1 , Justis P Ehlers  1   3
Affiliations

Predictive Assessment of Quantitative Ultra-Widefield Angiographic Features for Future Need for Anti-VEGF Therapy in Diabetic Eye Disease

Alice C Jiang et al. J Pers Med. .

Abstract

The objective of this study was to identify biomarkers that predict a future need for anti-VEGF therapy in diabetic retinopathy (DR). Eyes with DR that underwent ultra-widefield angiography (UWFA) and had at least a 1 year follow-up were grouped based on future anti-VEGF treatment requirements: (1) not requiring treatment, (2) immediate treatment (within 3 months of UWFA), and (3) delayed treatment (after 3 months of UWFA). Quantitative UWFA features and clinical factors were evaluated. Random forest models were built to differentiate eyes requiring immediate and delayed treatment from the eyes not requiring treatment. A total of 173 eyes were included. The mean follow-up was 22 (range: 11-43) months. The macular leakage index, panretinal leakage index, presence of DME, and visual acuity were significantly different in eyes requiring immediate (n = 38) and delayed (n = 34) treatment compared to eyes not requiring treatment (n = 101). Random forest model differentiating eyes requiring immediate treatment from eyes not requiring treatment demonstrated an AUC of 0.91 ± 0.07. Quantitative angiographic features have potential as important predictive biomarkers of a future need for anti-VEGF therapy in DR and may serve to guide the frequency of a follow-up.

Keywords: anti-VEGF; artificial intelligence; diabetic retinopathy; fluorescein angiography; personalized treatment; predicting anti-VEGF; predictive modeling; quantitative image analysis.

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Conflict of interest statement

The authors declare no conflict of interest specifically related to this article. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript, or in the decision to publish the results. The authors have the following financial disclosures: A.C.J.: None; D.D.S.: None; C.M.: None; J.W.: None, S.K.S.: Allergan (R, C); Leica (P), Zeiss (C); Regeneron (R, C); Eyepoint (R, C), Eyevensys (R, C), Novartis (C), Abbvie (C); K.E.T.: Zeiss (R); M.H.: None; J.L.R.: None; J.P.E.: Leica (C, P), Oxurion (C, R), Genentech (C, R), Roche (C, R), Zeiss (C), Alcon (C, R), Novartis (C, R), Aerpio (C, R), Allergan (C, R), Allegro (C), Regeneron (C, R), Alcon (C, R), Boehringer-Ingelheim (C, R), Stealth (C, R), Adverum (C, R).

Figures

Figure 1
Figure 1
Late UWFA images of eyes not requiring treatment (A), requiring delayed treatment (B) requiring immediate treatment (C), and their corresponding leakage (D–F), segmentation, and microaneurysm (G–I) segmentations.
Figure 2
Figure 2
Leakage index in eyes requiring future anti-VEGF therapy. Total leakage index and posterior pole leakage index on UWFA were significantly higher in eyes requiring future anti-VEGF therapy compared to eyes not requiring future injections.
Figure 3
Figure 3
MA count in eyes requiring future anti-VEGF therapy. Total MA count and posterior pole MA count on UWFA were significantly higher in eyes requiring future anti-VEGF therapy compared to eyes not requiring future injections.
Figure 4
Figure 4
Area under the curve graph for random forest model trained in 5-fold cross-validation setting differentiating eyes requiring immediate anti-VEGF treatment from eyes not requiring treatment.
See this image and copyright information in PMC

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