{
  "abstract": "Background: To evaluate the prognostic value of baseline optical coherence tomography (OCT) biomarkers and systemic factors for early and long-term anatomical response to anti-VEGF therapy in diabetic macular edema (DME).\n\nMethods: This retrospective study included 164 eyes from 105 patients with type 2 diabetes and DME who received three monthly loading doses of intravitreal bevacizumab (January 2013 to April 2024) and were subsequently managed with a pro re nata (PRN) regimen using standard retreatment criteria. Completion of the loading phase (minimum follow-up, 3 months) was required for inclusion. Anatomical response was assessed after the loading phase (early response) and at final follow-up (long-term response); eyes were classified as full, partial, or non-responders based on CMT and OCT morphology. Baseline demographic, systemic, and OCT characteristics were analyzed using generalized estimating equation (GEE) logistic regression to account for inter-eye correlation, followed by one-eye-per-patient sensitivity analyses.\n\nResults: After loading, 10 eyes (6.1%) were full responders, 72 (43.9%) partial responders, and 82 (50.0%) non-responders; 90% of early full responders maintained full response at final follow-up. In multivariable GEE analyses, higher baseline CMT, higher hyperreflective foci (HRF) count, and hyperreflective intraretinal material were independently associated with early anatomical response under the original percentage-reduction outcome definition; for long-term response, baseline CMT was only nominally associated and did not survive correction for multiple testing, and DRIL, EZ/ELM defect, and intraretinal cyst size were not significant. Both models showed moderate discrimination after bootstrap optimism correction (AUC 0.751 and 0.757, respectively). Sensitivity analyses across eye-selection strategies were consistent for baseline CMT, DRIL, EZ/ELM defect, and hyperreflective material, but intraretinal cyst size was unstable; all associations were sensitive to how anatomical response was defined.\n\nConclusions: Baseline OCT biomarkers showed candidate associations with anatomical response, but several, including the hyperreflective-material association, were not reproduced when the outcome was redefined using continuous final CMT or an absolute CMT threshold, despite robustness within the primary model. Discrimination was moderate (optimism-corrected AUC 0.75–0.76). These findings identify candidate prognostic OCT biomarkers requiring external validation before clinical application.\n\nSupplementary Information: The online version contains supplementary material available at https://doi.org/10.1186/s12886-026-05350-2.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Ophthalmology, Korgan State Hospital, 11A Bağ Street, Dolunay Neighborhood, Fatsa, Ordu Turkey",
    "Department of Ophthalmology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey"
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 3,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Tuğçe Özdemir"
    },
    {
      "affs": [
        1
      ],
      "name": "Gürkan Erdoğan"
    },
    {
      "affs": [
        1
      ],
      "name": "Zafer Cebeci"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/5tzcvt1my99v3.bib",
  "cited_by": 0,
  "doi": "10.1186/s12886-026-05350-2",
  "fulltext_url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC13732979/",
  "id": "5tzcvt1my99v3",
  "issns": [
    "1471-2415"
  ],
  "landing_url": "https://doi.org/10.1186/s12886-026-05350-2",
  "language": "en",
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Research"
    ],
    [
      "openalex",
      "2731|Retinal Diseases and Treatments"
    ]
  ],
  "openalex": "W7213472067",
  "pdf_url": null,
  "pmcid": "PMC13732979",
  "pmid": "42977930",
  "published": "2026-09-17",
  "publisher": "BMC",
  "ris": "https://research.draconitic.com/paper/5tzcvt1my99v3.ris",
  "sources": [
    {
      "first_seen": "2026-11-08T12:22:51Z",
      "native_id": "PMC13732979",
      "source": "pmc",
      "url": "https://doi.org/10.1186/s12886-026-05350-2"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2731|Retinal Diseases and Treatments",
      "subfield": "general"
    }
  ],
  "title": "Prognostic value of OCT biomarkers and systemic factors for early and long term anatomical treatment response in diabetic macular edema",
  "title_text": "Prognostic value of OCT biomarkers and systemic factors for early and long term anatomical treatment response in diabetic macular edema",
  "type": "peer-reviewed",
  "updated_at": "2026-11-08T12:22:51Z",
  "url": "https://research.draconitic.com/paper/5tzcvt1my99v3",
  "venue": "BMC Ophthalmology",
  "versions": []
}