Metabolic Changes In Aqueous Humor And Prognostic Implications In Diabetic Retinopathy Patients Undergoing Cataract Surgery With Intravitreal Anti-Vegf Therapy
Published 2025 - 43rd Congress of the ESCRS
Reference: PO275 | Type: Free paper
Authors: Rita Mencucci* 1 , Carla Rognoni 2 , Rosa Giglio 3
1Eye Clinic, Department of Neurosciences, Psychology, Drug Research and Child Health (NEUROFARBA), University of Florence,Florence,Italy, 2Centre for Research on Health and Social Care Management (CERGAS), SDA Bocconi School of Management, Bocconi University,milan,Italy, 3Department of Medicine, Surgery and Health Sciences, University Eye Clinic, University of Trieste,Trieste,Italy
Purpose
To explore changes in aqueous humor (AH) metabolites and their prognostic implications in NPDR patients undergoing cataract surgery (CS) with simultaneous intravitreal anti-VEGF injection.
Setting
Interventional; Real-World Randomized Controlled Trial
Methods
A randomized controlled trial was conducted, with a double-blind design. Forty-eight eyes were included, divided into the experimental group (phacoemulsification combined with intravitreal injection of conbercept and intraocular lens implantation) and the control group (phacoemulsification alone with intraocular lens implantation). Aqueous humor samples were collected intraoperatively and one week postoperatively. Ophthalmic examinations including best-corrected visual acuity (BCVA), intraocular pressure, and optical coherence tomography (OCT) were performed at one week, one month, two months, and three months postoperatively.
Results
No significant pre- and post-operative AH metabolite changes were observed in the control group. However, significant changes were seen in the experimental group, notably GABA, acetylcarnitine, and oxoglutaric acid. Pathway analysis revealed associations with the Malate-Aspartate Shuttle, Glucose-Alanine Cycle, and Alanine Metabolism. Metabolites like 4-Hydroxybenzoic acid, Aminocaproic acid, and xylose demonstrated high predictive capability for prognosis.
Conclusions
AH metabolite levels remain relatively stable post-CS, but intraoperative anti-VEGF alters their profile. Changes in metabolite levels are associated with prognosis, highlighting the feasibility and necessity of personalized preventive measures for potential post-cataract macular edema (PCME).