{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T12:12:22Z","timestamp":1791547942303,"version":"4.3.4"},"reference-count":50,"publisher":"BMJ","issue":"10","license":[{"start":{"date-parts":[[2025,5,16]],"date-time":"2025-05-16T00:00:00Z","timestamp":1747353600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Br J Ophthalmol"],"accepted":{"date-parts":[[2025,4,24]]},"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To establish the influence of different optical coherence tomography (OCT) biomarkers at baseline treatment on the potential response to anti-vascular endothelial growth factor (VEGF) treatment for diabetic macular oedema (DME).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Multicentric, retrospective, case-series study in patients with DME switched to dexamethasone implant injections (DEX-i) after anti-VEGF in real clinical practice. Biomarkers analysed on OCT images at baseline included intraretinal fluid (IRF), subretinal fluid (SRF), disorganisation of retinal inner layers (DRIL), disorganisation of retinal outer layers (DROL), hyperreflective foci (HRF), hyperreflective cystoid walls (HCW), dense intraretinal cyst (DIR) and vitreomacular interface (VMI) abnormalities. DME was classified according to the European School for Advanced Studies in Ophthalmology classification. Patients who were treated with anti-VEGF injections with an adequate response were selected as the control group.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      275 eyes were analysed in this study; 209 eyes (76.0%) switched from anti-VEGF to DEX-i were compared with 66 control eyes (24.0%). Patients who required switching were statistically older, showed worse initial BCVA and higher CRT. Logistic regression analyses showed that female gender, age, central retinal thickness, type of diabetes, SRF, HCW, DIR and VMI increase the likelihood of switching. The OR regarding the need to switch generated by the presence of two of these three factors (SRF, HCW, VMI) was 48.95. Having all three multiplies it by 4.56\u00d710\n                      <jats:sup>16<\/jats:sup>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>If baseline OCT shows two of SRF, HCW and VMI biomarkers at baseline, the risk of failure of anti-VEGF therapy is close to 50%. In the presence at baseline of all three biomarkers, failure of anti-VEGF therapy is almost certain.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bjo-2024-325665","type":"journal-article","created":{"date-parts":[[2025,5,16]],"date-time":"2025-05-16T13:20:18Z","timestamp":1747401618000},"page":"1155-1160","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":10,"title":["Biomarkers of risk of switching to dexamethasone implant for the treatment of diabetic macular oedema in real clinical practice: a multicentric study"],"prefix":"10.1136","volume":"109","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1105-9265","authenticated-orcid":false,"given":"Jorge","family":"Ruiz-Medrano","sequence":"first","affiliation":[{"name":"Servicio de Oftalmolog\u00eda, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain"},{"name":"Ocular Microsurgery Institute IMO, Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patricia","family":"Udaondo Mirete","sequence":"additional","affiliation":[{"name":"Ophthalmology Department, Hospital Universitario La Fe, Valencia, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marina","family":"Fern\u00e1ndez-Jim\u00e9nez","sequence":"additional","affiliation":[{"name":"Puerta de Hierro-Majadahonda University Hospital, Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Monica","family":"Asencio-Duran","sequence":"additional","affiliation":[{"name":"Hospital Universitario La Paz, IDIPAZ, Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8745-3464","authenticated-orcid":false,"given":"Jos\u00e9 Ignacio","family":"Fern\u00e1ndez-Vigo","sequence":"additional","affiliation":[{"name":"Ophthalmology, Hospital Universitario Cl\u00ednico San Carlos, Madrid, Spain"},{"name":"Ophthalmology, Centro Internacional de Oftalmolog\u00eda Avanzada, Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marta","family":"Medina-Baena","sequence":"additional","affiliation":[{"name":"Puerta del Mar University Hospital, C\u00e1diz, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4236-514X","authenticated-orcid":false,"given":"Ignacio","family":"Flores-Moreno","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Castilla-La Mancha University, Albacete, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jesus","family":"Pareja-Esteban","sequence":"additional","affiliation":[{"name":"Cl\u00ednica Rementer\u00eda, Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8346-3067","authenticated-orcid":false,"given":"Sara","family":"Touhami","sequence":"additional","affiliation":[{"name":"Hopitaux Universitaires Pitie Salpetriere-Charles Foix, Paris, \u00cele-de-France, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7918-7845","authenticated-orcid":false,"given":"Audrey","family":"Giocanti-Aur\u00e9gan","sequence":"additional","affiliation":[{"name":"Ophthalmology, Avicenne hospital, Hospital Avicenne, Bobigny, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2938-0409","authenticated-orcid":false,"given":"Maria Vittoria","family":"Cicinelli","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, University Vita-Salute, San Raffaele Hospital, Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anat","family":"Loewenstein","sequence":"additional","affiliation":[{"name":"Ophthalmology, Tel Aviv Medical Center, Tel Aviv, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jos\u00e9 M","family":"Ruiz-Moreno","sequence":"additional","affiliation":[{"name":"Ophthalmology, Castilla-La Mancha University, Albacete, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2025,5,16]]},"reference":[{"key":"2025121706501144000_109.10.1155.1","doi-asserted-by":"publisher","DOI":"10.3928\/23258160-20231031-02"},{"key":"2025121706501144000_109.10.1155.2","doi-asserted-by":"publisher","DOI":"10.1186\/s40662-015-0026-2"},{"key":"2025121706501144000_109.10.1155.3","doi-asserted-by":"publisher","DOI":"10.1016\/j.diabres.2018.02.023"},{"key":"2025121706501144000_109.10.1155.4","article-title":"Prognostic factors for the development and progression of proliferative diabetic retinopathy in people with diabetic retinopathy","volume":"2","author":"Perais","year":"2023","journal-title":"Cochrane Database Syst Rev"},{"key":"2025121706501144000_109.10.1155.5","doi-asserted-by":"publisher","DOI":"10.1016\/j.ophtha.2013.01.066"},{"key":"2025121706501144000_109.10.1155.6","doi-asserted-by":"publisher","DOI":"10.1177\/1120672118804079"},{"key":"2025121706501144000_109.10.1155.7","doi-asserted-by":"publisher","DOI":"10.1001\/jamaophthalmol.2015.5346"},{"key":"2025121706501144000_109.10.1155.8","doi-asserted-by":"publisher","DOI":"10.1001\/archophthalmol.2012.1107"},{"key":"2025121706501144000_109.10.1155.9","doi-asserted-by":"publisher","DOI":"10.4103\/IJO.IJO_893_23"},{"key":"2025121706501144000_109.10.1155.10","doi-asserted-by":"publisher","DOI":"10.1097\/IAE.0000000000002110"},{"key":"2025121706501144000_109.10.1155.11","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajo.2016.09.012"},{"key":"2025121706501144000_109.10.1155.12","doi-asserted-by":"publisher","DOI":"10.1001\/jamaophthalmol.2017.4914"},{"key":"2025121706501144000_109.10.1155.13","doi-asserted-by":"crossref","DOI":"10.1155\/2013\/920713","article-title":"Structural changes in individual retinal layers in diabetic macular edema","volume":"2013","author":"Murakami","year":"2013","journal-title":"J Diabetes Res"},{"key":"2025121706501144000_109.10.1155.14","doi-asserted-by":"publisher","DOI":"10.1177\/1120672120929960"},{"key":"2025121706501144000_109.10.1155.15","doi-asserted-by":"publisher","DOI":"10.1177\/1120672119880394"},{"key":"2025121706501144000_109.10.1155.16","doi-asserted-by":"publisher","DOI":"10.1159\/000458539"},{"key":"2025121706501144000_109.10.1155.17","doi-asserted-by":"crossref","first-page":"426","DOI":"10.1097\/APO.0000000000000312","article-title":"Diabetic Macular Edema Management in Asian Population: Expert Panel Consensus Guidelines","volume":"9","author":"Chhablani","year":"2020","journal-title":"Asia Pac J Ophthalmol (Phila)"},{"key":"2025121706501144000_109.10.1155.18","doi-asserted-by":"publisher","DOI":"10.1177\/2040622315590319"},{"key":"2025121706501144000_109.10.1155.19","doi-asserted-by":"publisher","DOI":"10.1159\/000515306"},{"key":"2025121706501144000_109.10.1155.20","doi-asserted-by":"crossref","DOI":"10.1155\/2015\/794036","article-title":"Updates in the management of diabetic macular edema","volume":"2015","author":"Mathew","year":"2015","journal-title":"J Diabetes Res"},{"key":"2025121706501144000_109.10.1155.21","doi-asserted-by":"publisher","DOI":"10.2147\/OPTH.S128509"},{"key":"2025121706501144000_109.10.1155.22","doi-asserted-by":"publisher","DOI":"10.1097\/IAE.0000000000001210"},{"key":"2025121706501144000_109.10.1155.23","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajo.2020.08.047"},{"key":"2025121706501144000_109.10.1155.24","doi-asserted-by":"publisher","DOI":"10.1097\/ICU.0000000000000424"},{"key":"2025121706501144000_109.10.1155.25","doi-asserted-by":"publisher","DOI":"10.1007\/s00417-022-05892-3"},{"key":"2025121706501144000_109.10.1155.26","doi-asserted-by":"publisher","DOI":"10.1186\/s12886-020-01637-0"},{"key":"2025121706501144000_109.10.1155.27","doi-asserted-by":"publisher","DOI":"10.1177\/1120672119848257"},{"key":"2025121706501144000_109.10.1155.28","doi-asserted-by":"publisher","DOI":"10.1007\/s00592-018-1151-x"},{"key":"2025121706501144000_109.10.1155.29","doi-asserted-by":"publisher","DOI":"10.1001\/jamaophthalmol.2014.2350"},{"key":"2025121706501144000_109.10.1155.30","doi-asserted-by":"publisher","DOI":"10.1016\/j.ophtha.2017.08.031"},{"key":"2025121706501144000_109.10.1155.31","doi-asserted-by":"publisher","DOI":"10.1167\/iovs.12-11503"},{"key":"2025121706501144000_109.10.1155.32","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajo.2011.03.033"},{"key":"2025121706501144000_109.10.1155.33","doi-asserted-by":"publisher","DOI":"10.1016\/j.ophtha.2016.02.022"},{"key":"2025121706501144000_109.10.1155.34","doi-asserted-by":"crossref","first-page":"539","DOI":"10.1001\/archopht.119.4.539","article-title":"Hydraulic Conductivity of Fixed Retinal Tissue After Sequential Excimer Laser Ablation: Barriers Limiting Fluid Distribution and Implications for Cystoid Macular Edema","volume":"119","author":"Antcliff","year":"2011","journal-title":"Arch Ophthalmol"},{"key":"2025121706501144000_109.10.1155.35","doi-asserted-by":"publisher","DOI":"10.1007\/s11892-012-0281-8"},{"key":"2025121706501144000_109.10.1155.36","doi-asserted-by":"crossref","first-page":"e19","DOI":"10.1111\/aos.14514","article-title":"Prediction of response to anti-vascular endothelial growth factor treatment in diabetic macular oedema using an optical coherence tomography-based machine learning method","volume":"99","author":"Cao","year":"2021","journal-title":"Acta Ophthalmol"},{"key":"2025121706501144000_109.10.1155.37","doi-asserted-by":"crossref","DOI":"10.1155\/2020\/6655021","article-title":"Optical Coherence Tomography (Angiography) Biomarkers in the Assessment and Monitoring of Diabetic Macular Edema","volume":"2020","author":"Suciu","year":"2020","journal-title":"J Diabetes Res"},{"key":"2025121706501144000_109.10.1155.38","doi-asserted-by":"publisher","DOI":"10.1167\/iovs.17-23042"},{"key":"2025121706501144000_109.10.1155.39","doi-asserted-by":"publisher","DOI":"10.1167\/iovs.18-25611"},{"key":"2025121706501144000_109.10.1155.40","doi-asserted-by":"publisher","DOI":"10.1167\/iovs.12-9950"},{"key":"2025121706501144000_109.10.1155.41","doi-asserted-by":"publisher","DOI":"10.1167\/iovs.13-11849"},{"key":"2025121706501144000_109.10.1155.42","doi-asserted-by":"publisher","DOI":"10.1097\/IAE.0b013e3181bd2c5a"},{"key":"2025121706501144000_109.10.1155.43","doi-asserted-by":"publisher","DOI":"10.1016\/j.ophtha.2015.09.032"},{"key":"2025121706501144000_109.10.1155.44","doi-asserted-by":"publisher","DOI":"10.1159\/000512195"},{"key":"2025121706501144000_109.10.1155.45","doi-asserted-by":"publisher","DOI":"10.1177\/1120672119861623"},{"key":"2025121706501144000_109.10.1155.46","doi-asserted-by":"publisher","DOI":"10.1177\/1120672118781236"},{"key":"2025121706501144000_109.10.1155.47","doi-asserted-by":"publisher","DOI":"10.1177\/11206721211052852"},{"key":"2025121706501144000_109.10.1155.48","doi-asserted-by":"publisher","DOI":"10.1001\/jamaophthalmol.2015.4070"},{"key":"2025121706501144000_109.10.1155.49","doi-asserted-by":"publisher","DOI":"10.1177\/1120672119857511"},{"key":"2025121706501144000_109.10.1155.50","doi-asserted-by":"crossref","DOI":"10.3390\/jcm13051327","article-title":"The Treatment of Diabetic Retinal Edema with Intravitreal Steroids: How and When","volume":"13","author":"Salvetat","year":"2024","journal-title":"J Clin Med"}],"container-title":["British Journal of Ophthalmology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bjo-2024-325665","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,17]],"date-time":"2025-12-17T14:50:49Z","timestamp":1765983049000},"score":1,"resource":{"primary":{"URL":"https:\/\/bjo.bmj.com\/lookup\/doi\/10.1136\/bjo-2024-325665"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,5,16]]},"references-count":50,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2025,9,23]]},"published-print":{"date-parts":[[2025,10]]}},"alternative-id":["10.1136\/bjo-2024-325665"],"URL":"https:\/\/doi.org\/10.1136\/bjo-2024-325665","relation":{},"ISSN":["0007-1161","1468-2079"],"issn-type":[{"value":"0007-1161","type":"print"},{"value":"1468-2079","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,5,16]]}}}