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Biomarkers of Myopic Choroidal Neovascularization in Women, Determining the Clinical Course and Response to Anti-VEGF Therapy

https://doi.org/10.29413/ABS.2021-6.2.12

Abstract

Aim: to identify clinical and laboratory biomarkers that determine the nature of the course of myopic choroidal neovascularization (mCNV) and the response to anti-VEGF therapy in women.

Material and methods. A prospective non-randomized study was conducted in 52 patients (52 eyes) with active mCNV, treated with ranibizumab intravitreally, 0.5mg. After 12months, the suppression of CNV activity, the number of injections and the fellow eye inclusion in the pathological process were taken into account. There were 2 groups: with a favorable clinical course (n = 31, age – 33,0 ± 5,1 years, anterior-posterior axis (APA) 28,5 ± 0,3 mm) and an unfavorable clinical course (n = 21, age – 34,0 ± 4,1 years, APA – 29,01 ± 0,1 mm). Structural retinal changes, choroid thickness, retinal blood flow, and heart rate were evaluated using OCT and OCTA protocols (Optovue XR Avanti, USA). Studies were conducted before the start of therapy and then one time per month. The concentration of sex and pituitary hormones (ELISA analyzer “Immunohem-2100”), lipoprotein A, Apo B/Apo A (Accent 200 Cormay, Poland), coagulogram data (Helena C-2, UK), and the concentration of highly sensitive C-reactive protein in blood serum before the start of antiangiogenic therapy were studied once.

Results. In the first group, 1.4 ± 0.7 ranibizumab injections were administered to suppress the CNV activity. In the opposite group – 3.5 ± 2.1 injections, in 73.7 % of cases, relapses were diagnosed, in 3 cases – primary CNV in the fellow eye. Clinical and laboratory biomarkers of the unfavorable clinical course of mCNV were identified: extreme choroidal thinning, highly organized membranes of a large area, dome-shaped deformation of the posterior pole, excess of the reference values of lipoprotein A, fibrinogen and highly sensitive C-reactive protein by two or more times, an imbalance of sex and pituitary hormones (excess of the reference values of prolactin, follicle stimulating hormone, cortisol, progesterone concentration decrease), a predominant change in the menstrual-ovarian cycle according to the type of amenorrhea and opsomenorrhea.

Conclusion. Myopic CNV biomarkers in women allow predicting the response to anti-VEGF therapy, the formation of relapses and the inclusion of the fellow eye in the pathological process. 

About the Authors

A. V. Grigorieva
Irkutsk Branch of S.N. Fyodorov Eye Microsurgery Federal State Institution
Russian Federation

Cand. Sc. (Med.), Ophthalmologist,

Lermontov str. 337, Irkutsk 664033



T. N. Iureva
Irkutsk Branch of S.N. Fyodorov Eye Microsurgery Federal State Institution; Irkutsk State Medical Academy of Postgraduate Education – Branch Campus of the Russian Medical Academy of Continuing Professional Education; Irkutsk State Medical University
Russian Federation

Dr. Sc. (Med.), Professor, Deputy Director for Science, Lermontov str. 337, Irkutsk 664033;

Professor at the Department of Ophthalmology, Yubileyniy 100, Irkutsk 664049;

Professor at the Department of Eye Diseases, Krasnogo Vosstania str. 1, Irkutsk 664003



Ju. V. Kursakova
Irkutsk Branch of S.N. Fyodorov Eye Microsurgery Federal State Institution
Russian Federation

Head of the Laboratory, 

Lermontov str. 337, Irkutsk 664033



E. I. Ivanova
Irkutsk State Medical University
Russian Federation

Teaching Assistant at the Department of Obstetrics and Gynecology with the Course of Gynecology of Children and Adolescents, 

Krasnogo Vosstania str. 1, Irkutsk 664003



D. Yu. Samsonov
Irkutsk Branch of S.N. Fyodorov Eye Microsurgery Federal State Institution
Russian Federation

Cand. Sc. (Med.), Ophthalmologist,

Lermontov str. 337, Irkutsk 664033



I. M. Mikhalevich
Irkutsk State Medical Academy of Postgraduate Education – Branch Campus of the Russian Medical Academy of Continuing Professional Education
Russian Federation

Cand. Sc. (Geolog.-Mineral.), Associate professor, Head of the Department of Informatics, 

Yubileyniy 100, Irkutsk 664049



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Review

For citations:


Grigorieva A.V., Iureva T.N., Kursakova J.V., Ivanova E.I., Samsonov D.Yu., Mikhalevich I.M. Biomarkers of Myopic Choroidal Neovascularization in Women, Determining the Clinical Course and Response to Anti-VEGF Therapy. Acta Biomedica Scientifica. 2021;6(2):105-113. (In Russ.) https://doi.org/10.29413/ABS.2021-6.2.12

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