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. 2025 Mar 18;18(3):454-461.
doi: 10.18240/ijo.2025.03.12. eCollection 2025.

Renal dysfunction associated with clinical response to intravitreal conbercept therapy for diabetic macular edema

Wei Wu  1 , Hui-Dong Liu  2 , Xue Xiao  2 , Ya-Xin Wang  2 , Song-Fu Feng  2 , Jia-Qi Liu  2 , Yong-Gang Yuan  1 , Xiao-He Lu  2
Affiliations

Renal dysfunction associated with clinical response to intravitreal conbercept therapy for diabetic macular edema

Wei Wu et al. Int J Ophthalmol. .

Abstract

Aim: To investigate the impact of renal dysfunction on clinical response to intravitreal conbercept injection (IVC) for diabetic macular edema (DME).

Methods: This retrospective study included a total of 100 eyes from 100 patients with DME treated with IVC with 3+PRN regimen. Based on the estimated glomerular filtration rate (eGFR), the patients were divided into normal renal function group (n=37), impaired renal function group (n=27), and renal insufficiency group (n=36). The main outcome measures were best-corrected visual acuity (BCVA) and central subfield macular thickness (CST). Clinical parameters included blood urea nitrogen, serum creatinine, serum uric acid, glycosylated hemoglobin (HbA1c), and hemoglobin.

Results: The mean follow-up time was 3.9mo. The mean number of IVCs was 2.07±1.22 in the three groups. Mean BCVA improved significantly from 0.81±0.49 logMAR at baseline to 0.72±0.52 logMAR in the three groups at the final visit (P<0.001). Mean CST decreased significantly from 427.85±148.99 µm at baseline to 275.31±108.31 µm at final visit (P<0.001). Patients in the normal renal function group had higher baseline hemoglobin levels and thinner baseline CST than those in the impaired renal function and insufficiency renal function group (all P<0.001). Patients in the normal renal function group had higher baseline hemoglobin levels and thinner baseline CST than those in the impaired renal function and insufficiency renal function group (all P<0.001). The three groups had no differences in baseline HbA1c levels (P>0.05). Good baseline BCVA (logMAR, P=0.001) and thicker baseline CST (P=0.041) were associated with visual acuity improvement. Higher eGFR (P<0.001), hemoglobin (P=0.032) and thicker baseline CST (P=0.017) were associated with macular edema retrogression in the conbercept-treated diabetic patients, which showed better anatomical response to IVC.

Conclusion: Our results indicate that the renal dysfunction is the risk factor associated with the efficacy of IVC for DME.

Keywords: conbercept; diabetic macular edema; renal dysfunction.

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Conflict of interest statement

Conflicts of Interest: Wu W, None; Liu HD, None; Xiao X, None; Wang YX, None; Feng SF, None; Liu JQ, None; Yuan YG, None; Lu XH, None.

Figures

Figure 1
Figure 1. Design proposal of the research
NPDR: Nonproliferative diabetic retinopathy; PDR: Proliferative diabetic retinopathy; eGFR: Estimated glomerular filtration rate; BUN: Blood urea nitrogen; CREA: Serum creatintine; UA: Uric acid.
Figure 2
Figure 2. Alteration of CST during the follow-up visits by spectral domain optical coherence tomography
A: DME patient with eGFR<30 mL/min·1.73 m2, CST was 762 µm at baseline; B: CST decreased to 186 µm 1wk after 6 intravitreous conbercept injections. DME: Diabetic macular edema; CST: Central subfield macular thickness; eGFR: Estimated glomerular filtration rate.
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