Abstract
Diabetic retinopathy (DR) is the most common microvascular complication of diabetes mellitus (DM) and the leading cause of blindness in patients with DM. In the pathogenesis of DR, chronic hyperglycemia leads to biochemical and structural alterations in retinal blood vessels’ wall, resulting in hyperpermeability and non-perfusion. Since vascular endothelial growth factor (VEGF) has been found to play a significant role in the pathogenesis of DR, this review sheds light on the effect of intravitreal anti-VEGF agents on retinal non-perfusion in patients with DR. Based on the existing literature, anti-VEGF agents have been shown to improve DR severity, although they cannot reverse retinal ischemia. The results of the published studies are controversial and differ based on the location of retinal non-perfusion, as well as the imaging modality used to assess retinal non-perfusion. In cases of macular non-perfusion, most of studies showed no change in both fundus fluorescein angiography (FFA) and optical coherence tomography (OCTA) in patients with DR treated with intravitreal anti-VEGF agents, while few studies reported worsening of non-perfusion with enlargement of foveal avascular zone (FAZ). Regarding peripheral ischemia, studies using wide-field-FFA demonstrated an improvement or stability in non-perfusion areas after anti-VEGF treatment. However, the use of wide-field-OCTA revealed no signs of re-perfusion of retinal vessels post anti-VEGF treatment. Further prospective studies with long follow-up and large sample size are still needed to draw solid conclusions.
摘要
糖尿病视网膜病变 (DR) 是糖尿病 (DM) 最常见的微血管并发症, 也是DM患者致盲的主要原因。在DR的发病机制中, 慢性高血糖会引起视网膜血管壁的生化和结构发生改变, 并导致高渗和无灌注。由于血管内皮生长因子 (VEGF) 在DR的发病机制中起着重要作用, 本文综述了玻璃体内抗VEGF药物对DR患者视网膜非灌注区的影响。根据现有文献, 抗VEGF药物已被证明可以改善DR的严重程度, 但仍不能逆转视网膜缺血。目前已发表的研究结果存在争议, 并根据视网膜无灌注的位置以及用于评估视网膜无灌注的成像方式而有所不同。在黄斑区无灌注的病例中, 大多数研究报道了玻璃体内抗VEGF药物治疗后的DR患者, 其眼底荧光素血管造影(FFA)和光学相干断层成像(OCTA)均无变化, 而少数研究则报道了无灌注区域的加重伴随中央凹无血管区(FAZ)的增大。关于外周缺血, 使用广角FFA的研究表明, 抗VEGF治疗后的无灌注区有一定的改善或稳定。然而, 在抗VEGF治疗后, 使用广角OCTA并未发现视网膜血管有再灌注的迹象。未来还需要进一步的长期随访和大样本的前瞻性研究才能得出可靠的结论。
Similar content being viewed by others
Log in or create a free account to read this content
Gain free access to this article, as well as selected content from this journal and more on nature.com
or
References
International Diabetes Federation. IDF Diabetes Atlas. 7th ed. Brussels, Belgium: International Diabetes Federation; 2015.
Das A. Diabetic retinopathy: battling the global epidemic. Invest Ophthalmol Vis Sci. 2016;57:6669–82.
Forbes JM, Cooper ME. Mechanisms of diabetic complications. Physiol Rev. 2013;93:137–88.
Antonetti DA, Klein R, Gardner TW. Diabetic retinopathy. New Engl J Med. 2012;366:1227–39.
Yau JW, Rogers SL, Kawasaki R, Lamoureux EL, Kowalski JW, Bek T, et al. Global prevalence and major risk factors of diabetic retinopathy. Diabetes Care. 2012;35:556–64.
Klein R, Klein BE, Moss SE, Cruickshanks KJ. The Wisconsin Epidemiologic Study of Diabetic Retinopathy. XV. The long-term incidence of macular edema. Ophthalmology. 1995;102:7–16.
Das A, McGuire PG, Rangasamy S. Diabetic macular edema: pathophysiology and novel therapeutic targets. Ophthalmology. 2015;122:1375–94.
Romero-Aroca P, Baget-Bernaldiz M, Pareja-Rios A, Lopez-Galvez M, Navarro-Gil R, Verges R. Diabetic macular edema pathophysiology: vasogenic versus inflammatory. J Diabetes Res. 2016;2016:2156273.
Liu Y, Shen J, Fortmann SD, Wang J, Vestweber D, Campochiaro PA. Reversible retinal vessel closure from VEGF-induced leukocyte plugging. JCI insight. 2017;2:e95530.
Osborne NN, Casson RJ, Wood JP, Chidlow G, Graham M, Melena J. Retinal ischemia: mechanisms of damage and potential therapeutic strategies. Prog Retin Eye Res. 2004;23:91–147.
Sim DA, Keane PA, Rajendram R, Karampelas M, Selvam S, Powner MB, et al. Patterns of peripheral retinal and central macula ischemia in diabetic retinopathy as evaluated by ultra-widefield fluorescein angiography. Am J Ophthalmol. 2014;158:144–53.
Mitchell P, McAllister I, Larsen M, Staurenghi G, Korobelnik JF, Boyer DS, et al. Evaluating the impact of intravitreal aflibercept on diabetic retinopathy progression in the VIVID-DME and VISTA-DME studies. Ophthalmol Retina. 2018;2:988–96.
Bressler SB, Odia I, Glassman AR, Danis RP, Grover S, Hampton GR, et al. Changes in diabetic retinopathy severity when treating diabetic macular edema with ranibizumab: DRCR.net Protocol I 5-Year Report. Retina. 2018;38:1896–904.
Bressler SB, Liu D, Glassman AR, Blodi BA, Castellarin AA, Jampol LM, et al. Change in diabetic retinopathy through 2 years: secondary analysis of a randomized clinical trial comparing aflibercept, bevacizumab, and ranibizumab. JAMA Ophthalmol. 2017;135:558–68.
Wykoff CC, Nittala MG, Zhou B, Fan W, Velaga SB, Lampen SIR, et al. Intravitreal aflibercept for retinal nonperfusion in proliferative diabetic retinopathy: outcomes from the randomized RECOVERY trial. Ophthalmol Retina. 2019;3:1076–86.
Bonnin S, Dupas B, Lavia C, Erginay A, Dhundass M, Couturier A, et al. Anti-vascular endothelial growth factor therapy can improve diabetic retinopathy score without change in retinal perfusion. Retina. 2019;39:426–34.
Dorrell MI, Aguilar E, Scheppke L, Barnett FH, Friedlander M. Combination angiostatic therapy completely inhibits ocular and tumor angiogenesis. Proc Natl Acad Sci USA. 2007;104:967–72.
Baffert F, Le T, Sennino B, Thurston G, Kuo CJ, Hu-Lowe D, et al. Cellular changes in normal blood capillaries undergoing regression after inhibition of VEGF signaling. Am J Physiol Heart Circ Physiol. 2006;290:H547–559.
Manousaridis K, Talks J. Macular ischaemia: a contraindication for anti-VEGF treatment in retinal vascular disease? Br J Ophthalmol. 2012;96:179–84.
Whitehead M, Wickremasinghe S, Osborne A, Van Wijngaarden P, Martin KR. Diabetic retinopathy: a complex pathophysiology requiring novel therapeutic strategies. Expert Opin Biol Ther. 2018;18:1257–70.
Gan J, Huang M, Lan G, Liu L, Xu F. High glucose induces the loss of retinal pericytes partly via NLRP3-caspase-1-GSDMD-mediated pyroptosis. Biomed Res Int. 2020;2020:4510628.
Banks WA. The blood-brain barrier interface in diabetes mellitus: dysfunctions, mechanisms and approaches to treatment. Curr Pharm Des. 2020;26:1438–47.
Eleftheriou CG, Ivanova E, Sagdullaev BT. Of neurons and pericytes: the neuro-vascular approach to diabetic retinopathy. Vis Neurosci. 2020;37:E005.
Roy S, Kim D. Retinal capillary basement membrane thickening: Role in the pathogenesis of diabetic retinopathy. Prog Retin Eye Res 2021;82:100903.
Haritoglou C, Maier M, Neubauer AS, Augustin AJ. Current concepts of pharmacotherapy of diabetic macular edema. Expert Opin Pharmacother. 2020;21:467–75.
Gross JG, Glassman AR, Liu D, Sun JK, Antoszyk AN, Baker CW, et al. Five-year outcomes of panretinal photocoagulation vs intravitreous ranibizumab for proliferative diabetic retinopathy: a randomized clinical trial. JAMA Ophthalmol. 2018;136:1138–48.
Sivaprasad S, Prevost AT, Vasconcelos JC, Riddell A, Murphy C, Kelly J, et al. Clinical efficacy of intravitreal aflibercept versus panretinal photocoagulation for best corrected visual acuity in patients with proliferative diabetic retinopathy at 52 weeks (CLARITY): a multicentre, single-blinded, randomised, controlled, phase 2b, non-inferiority trial. Lancet. 2017;389:2193–203.
Funatsu H, Noma H, Mimura T, Eguchi S, Hori S. Association of vitreous inflammatory factors with diabetic macular edema. Ophthalmology. 2009;116:73–79.
Sfikakis PP, Markomichelakis N, Theodossiadis GP, Grigoropoulos V, Katsilambros N, Theodossiadis PG. Regression of sight-threatening macular edema in type 2 diabetes following treatment with the anti-tumor necrosis factor monoclonal antibody infliximab. Diabetes Care. 2005;28:445–7.
Sfikakis PP, Grigoropoulos V, Emfietzoglou I, Theodossiadis G, Tentolouris N, Delicha E, et al. Infliximab for diabetic macular edema refractory to laser photocoagulation: a randomized, double-blind, placebo-controlled, crossover, 32-week study. Diabetes Care. 2010;33:1523–8.
Khan M, Aziz AA, Shafi NA, Abbas T, Khanani AM. Targeting angiopoietin in retinal vascular diseases: a literature review and summary of clinical trials involving faricimab. Cells. 2020;9:1869.
Saharinen P, Eklund L, Alitalo K. Therapeutic targeting of the angiopoietin-TIE pathway. Nat Rev Drug Discov. 2017;16:635–61.
Abdulaal M, Haddad NM, Sun JK, Silva PS. The role of plasma kallikrein-kinin pathway in the development of diabetic retinopathy: pathophysiology and therapeutic approaches. Semin Ophthalmol. 2016;31:19–24.
Simó R, Stitt AW, Gardner TW. Neurodegeneration in diabetic retinopathy: does it really matter? Diabetologia. 2018;61:1902–12.
Miller DJ, Cascio MA, Rosca MG. Diabetic retinopathy: the role of mitochondria in the neural retina and microvascular disease. Antioxidants. 2020;9:E905.
Gardner TW, Davila JR. The neurovascular unit and the pathophysiologic basis of diabetic retinopathy. Graefes Arch Clin Exp Ophthalmol. 2017;255:1–6.
Cicinelli MV, Cavalleri M, Brambati M, Lattanzio R, Bandello F. New imaging systems in diabetic retinopathy. Acta Diabetol. 2019;56:981–94.
Cole ED, Novais EA, Louzada RN, Waheed NK. Contemporary retinal imaging techniques in diabetic retinopathy: a review. Clin Exp Ophthalmol. 2016;44:289–99.
Or C, Sabrosa AS, Sorour O, Arya M, Waheed N. Use of OCTA, FA, and ultra-widefield imaging in quantifying retinal ischemia: a review. Asia Pac J Ophthalmol. 2018;7:46–51.
Liu TYA, Arevalo JF. Wide-field imaging in proliferative diabetic retinopathy. Int J Retina Vitreous. 2019;5:20.
Rabiolo A, Parravano M, Querques L, Cicinelli MV, Carnevali A, Sacconi R, et al. Ultra-wide-field fluorescein angiography in diabetic retinopathy: a narrative review. Clin Ophthalmol. 2017;11:803–7.
Tey KY, Teo K, Tan ACS, Devarajan K, Tan B, Tan J, et al. Optical coherence tomography angiography in diabetic retinopathy: a review of current applications. Eye Vis. 2019;6:37.
Tran K, Pakzad-Vaezi K. Multimodal imaging of diabetic retinopathy. Curr Opin Ophthalmol. 2018;29:566–75.
Zhang Q, Rezaei KA, Saraf SS, Chu Z, Wang F, Wang RK. Ultra-wide optical coherence tomography angiography in diabetic retinopathy. Quant Imaging Med Surg 2018;8:743–53.
Pichi F, Smith SD, Abboud EB, Neri P, Woodstock E, Hay S, et al. Wide-field optical coherence tomography angiography for the detection of proliferative diabetic retinopathy. Graefes Arch Clin Exp Ophthalmol. 2020;258:1901–9.
Nicholson L, Ramu J, Chan EW, Bainbridge JW, Hykin PG, Talks SJ, et al. Retinal nonperfusion characteristics on ultra-widefield angiography in eyes with severe nonproliferative diabetic retinopathy and proliferative diabetic retinopathy. JAMA Ophthalmol. 2019;137:626–31.
Shibuya M. Differential roles of vascular endothelial growth factor receptor-1 and receptor-2 in angiogenesis. J Biochem Mol Biol. 2006;39:469–78.
Tolentino MJ, Miller JW, Gragoudas ES, Jakobiec FA, Flynn E, Chatzistefanou K, et al. Intravitreous injections of vascular endothelial growth factor produce retinal ischemia and microangiopathy in an adult primate. Ophthalmology. 1996;103:1820–8.
Neubauer AS, Kook D, Haritoglou C, Priglinger SG, Kampik A, Ulbig M, et al. Bevacizumab and retinal ischemia. Ophthalmology. 2007;114:2096.
Kook D, Wolf A, Kreutzer T, Neubauer A, Strauss R, Ulbig M, et al. Long-term effect of intravitreal bevacizumab (avastin) in patients with chronic diffuse diabetic macular edema. Retina. 2008;28:1053–60.
Michaelides M, Fraser-Bell S, Hamilton R, Kaines A, Egan C, Bunce C, et al. Macular perfusion determined by fundus fluorescein angiography at the 4-month time point in a prospective randomized trial of intravitreal bevacizumab or laser therapy in the management of diabetic macular edema (Bolt Study): report 1. Retina. 2010;30:781–6.
Comyn O, Sivaprasad S, Peto T, Neveu MM, Holder GE, Xing W, et al. A randomized trial to assess functional and structural effects of ranibizumab versus laser in diabetic macular edema (the LUCIDATE study). Am J Ophthalmol. 2014;157:960–70.
Douvali M, Chatziralli IP, Theodossiadis PG, Chatzistefanou KI, Giannakaki E, Rouvas AA. Effect of macular ischemia on intravitreal ranibizumab treatment for diabetic macular edema. Ophthalmologica. 2014;232:136–43.
Chandra S, Sheth J, Anantharaman G, Gopalakrishnan M. Ranibizumab-induced retinal reperfusion and regression of neovascularization in diabetic retinopathy: An angiographic illustration. Am J Ophthalmol Case Rep. 2018;9:41–44.
Busch C, Wakabayashi T, Sato T, Fukushima Y, Hara C, Shiraki N, et al. Retinal microvasculature and visual acuity after intravitreal aflibercept in diabetic macular edema: an optical coherence tomography angiography study. Sci Rep. 2019;9:1561.
Hsieh YT, Alam MN, Le D, Hsiao CC, Yang CH, Chao DL, et al. OCT angiography biomarkers for predicting visual outcomes after ranibizumab treatment for diabetic macular edema. Ophthalmol Retina. 2019;3:826–34.
Couturier A, Rey PA, Erginay A, Lavia C, Bonnin S, Dupas B, et al. Widefield OCT-angiography and fluorescein angiography assessments of nonperfusion in diabetic retinopathy and edema treated with anti-vascular endothelial growth factor. Ophthalmology. 2019;126:1685–94.
Sugimoto M, Ichio A, Mochida D, Tenma Y, Miyata R, Matsubara H, et al. Multiple effects of intravitreal aflibercept on microvascular regression in eyes with diabetic macular edema. Ophthalmol Retina. 2019;3:1067–75.
Pereira F, Godoy BR, Maia M, Regatieri CV. Microperimetry and OCT angiography evaluation of patients with ischemic diabetic macular edema treated with monthly intravitreal bevacizumab: a pilot study. Int J Retin Vitreous. 2019;5:24.
Figueiredo N, Srivastava SK, Singh RP, Babiuch A, Sharma S, Rachitskaya A, et al. Longitudinal panretinal leakage and ischemic indices in retinal vascular disease after aflibercept therapy: The PERMEATE Study. Ophthalmol Retina. 2020;4:154–63.
Elnahry AG, Abdel-Kader AA, Raafat KA, Elrakhawy K. Evaluation of changes in macular perfusion detected by optical coherence tomography angiography following 3 intravitreal monthly bevacizumab injections for diabetic macular edema in the IMPACT Study. J Ophthalmol. 2020;2020:5814165.
Statler B, Conti TF, Conti FF, Silva FQ, Rachitskaya A, Yuan A, et al. Twenty-four-month OCTA assessment in diabetic patients undergoing fixed-interval intravitreal aflibercept therapy. Ophthalmic Surg Lasers Imaging Retina. 2020;51:448–55.
Lee SJ, Shin IC, Jeong IW, Choi CW, Yang YS. Prospective, single-center, six-month study of intravitreal ranibizumab for macular edema with nonproliferative diabetic retinopathy: effects on microaneurysm turnover and non-perfused retinal area. Clin Ophthalmol. 2020;14:1609–18.
Lee SJ, Koh HJ. Enlargement of the foveal avascular zone in diabetic retinopathy after adjunctive intravitreal bevacizumab (avastin) with pars plana vitrectomy. J Ocul Pharm Ther. 2009;25:173–4.
Erol N, Gursoy H, Kimyon S, Topbas S, Colak E. Vision, retinal thickness, and foveal avascular zone size after intravitreal bevacizumab for diabetic macular edema. Adv Ther. 2012;29:359–69.
Ghasemi Falavarjani K, Iafe NA, Hubschman JP, Tsui I, Sadda SR, Sarraf D. Optical coherence tomography angiography analysis of the foveal avascular zone and macular vessel density after anti-VEGF therapy in eyes with diabetic macular edema and retinal vein occlusion. Invest Ophthalmol Vis Sci. 2017;58:30–34.
Moon BG, Um T, Lee J, Yoon YH. Correlation between deep capillary plexus perfusion and long-term photoreceptor recovery after diabetic macular edema treatment. Ophthalmol Retina. 2018;2:235–43.
Babiuch AS, Conti TF, Conti FF, Silva FQ, Rachitskaya A, Yuan A, et al. Diabetic macular edema treated with intravitreal aflibercept injection after treatment with other anti-VEGF agents (SWAP-TWO study): 6-month interim analysis. Int J Retina Vitreous. 2019;5:17.
Conti FF, Song W, Rodrigues EB, Singh RP. Changes in retinal and choriocapillaris density in diabetic patients receiving anti-vascular endothelial growth factor treatment using optical coherence tomography angiography. Int J Retina Vitreous. 2019;5:41.
Mirshahi R, Falavarjani KG, Molaei S, Habibi A, Anvari P, Khorasani MA, et al. Macular microvascular changes after intravitreal bevacizumab injection in diabetic macular edema. Can J Ophthalmol. 2021;56:57–65.
Goel N, Kumar V, Ghosh B. Ischemic maculopathy following intravitreal bevacizumab for refractory diabetic macular edema. Int Ophthalmol. 2011;31:39–42.
Feucht N, Schönbach EM, Lanzl I, Kotliar K, Lohmann CP, Maier M. Changes in the foveal microstructure after intravitreal bevacizumab application in patients with retinal vascular disease. Clin Ophthalmol. 2013;7:173–8.
Campochiaro PA, Wykoff CC, Shapiro H, Rubio RG, Ehrlich JS. Neutralization of vascular endothelial growth factor slows progression of retinal nonperfusion in patients with diabetic macular edema. Ophthalmology. 2014;121:1783–9.
Levin AM, Rusu I, Orlin A, Gupta MP, Coombs P, D’Amico DJ, et al. Retinal reperfusion in diabetic retinopathy following treatment with anti-VEGF intravitreal injections. Clin Ophthalmol. 2017;11:193–200.
Karst SG, Deak GG, Gerendas BS, Waldstein SM, Lammer J, Simader C, et al. Association of changes in macular perfusion with ranibizumab treatment for diabetic macular edema: a subanalysis of the RESTORE (Extension) study. JAMA Ophthalmol. 2018;136:315–21.
Michalska-Małecka K, Heinke, Knudsen A. Optical coherence tomography angiography in patients with diabetic retinopathy treated with anti-VEGF intravitreal injections: case report. Medicine. 2017;96:e8379.
Gupta MP, Kiss S, Chan RVP. Reversal of retinal vascular leakage and arrest of progressive retinal nonperfusion with monthly anti-vascular endothelial growth factor therapy for proliferative diabetic retinopathy. Retina. 2018;38:e74–e75.
Sorour OA, Sabrosa AS, Yasin Alibhai A, Arya M, Ishibazawa A, Witkin AJ, et al. Optical coherence tomography angiography analysis of macular vessel density before and after anti-VEGF therapy in eyes with diabetic retinopathy. Int Ophthalmol. 2019;39:2361–71.
Dastiridou A, Karathanou K, Riga P, Anagnostopoulou S, Balasubramanian S, Mataftsi A, et al. OCT angiography study of the macula in patients with diabetic macular edema treated with intravitreal aflibercept. Ocul Immunol Inflamm. 2020 (in press).
Barash A, Chui TYP, Garcia P, Rosen RB. Acute macular and peripapillary angiographic changes with intravitreal injections. Retina. 2020;40:648–56.
Wykoff CC, Shah C, Dhoot D, Coleman HR, Thompson D, Du W, et al. Longitudinal retinal perfusion status in eyes with diabetic macular edema receiving intravitreal aflibercept or laser in VISTA study. Ophthalmology. 2019;126:1171–80.
Filek R, Hooper P, Sheidow TG, Gonder J, Chakrabarti S, Hutnik CM. Two-year analysis of changes in the optic nerve and retina following anti-VEGF treatments in diabetic macular edema patients. Clin Ophthalmol. 2019;13:1087–96.
Gill A, Cole ED, Novais EA, Louzada RN, de Carlo T, Duker JS, et al. Visualization of changes in the foveal avascular zone in both observed and treated diabetic macular edema using optical coherence tomography angiography. Int J Retina Vitreous. 2017;3:19.
Nguyen QD, Brown DM, Marcus DM, Boyer DS, Patel S, Feiner L, et al. Ranibizumab for diabetic macular edema: results from 2 phase III randomized trials: RISE and RIDE. Ophthalmology. 2012;119:789–801.
Brown DM, Nguyen QD, Marcus DM, Boyer DS, Patel S, Feiner L, et al. Long-term outcomes of ranibizumab therapy for diabetic macular edema: the 36-month results from two phase III trials: RISE and RIDE. Ophthalmology. 2013;120:2013–22.
Wykoff CC, Eichenbaum DA, Roth DB, Hill L, Fung AE, Haskova Z. Ranibizumab induces regression of diabetic retinopathy in most patients at high risk of progression to proliferative diabetic retinopathy. Ophthalmol Retina. 2018;2:997–1009.
Takahashi K, Kishi S, Muraoka K, Shimizu K. Reperfusion of occluded capillary beds in diabetic retinopathy. Am J Ophthalmol. 1998;126:791–7.
Chatziralli I, Dimitriou E, Theodossiadis G, Kazantzis D, Theodossiadis P. Intravitreal ranibizumab alone or in combination with panretinal photocoagulation for the treatment of proliferative diabetic retinopathy with coexistent macular edema: long-term outcomes of a prospective study. Acta Diabetol. 2020;57:1219–25.
Author information
Authors and Affiliations
Contributions
IC conceived the idea of the review, collected data, extracted data, analyzed and interpreted data, and drafted the manuscript; ST critically revised the manuscript; MVC provided data and critically revised the manuscript; CA and ED collected data, extracted data, and drafted the manuscript; GT and PT critically revised the manuscript. All authors have read and approved the current version of the manuscript.
Corresponding author
Ethics declarations
Competing interests
The authors declare no competing interests.
Additional information
Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
About this article
Cite this article
Chatziralli, I., Touhami, S., Cicinelli, M.V. et al. Disentangling the association between retinal non-perfusion and anti-VEGF agents in diabetic retinopathy. Eye 36, 692–703 (2022). https://doi.org/10.1038/s41433-021-01750-4
Received:
Revised:
Accepted:
Published:
Issue date:
DOI: https://doi.org/10.1038/s41433-021-01750-4
This article is cited by
-
New targets in diabetic retinopathy: addressing limitations of current treatments through the Sema3A/Nrp1 pathway
Eye (2025)
-
Quantitative evaluation of ocular vascularity and correlation analysis in patients with diabetic retinopathy by SMI and OCTA
BMC Ophthalmology (2024)
-
What is Occluding Our Understanding of Retinal Vein Occlusion?
Ophthalmology and Therapy (2024)
-
Vascular endothelial growth factor and its receptors regulation in gestational diabetes mellitus and eclampsia
Journal of Translational Medicine (2022)
-
Comment on: Disentangling the association between retinal non-perfusion and anti-VEGF agents in diabetic retinopathy
Eye (2022)
