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Figueras Ventura, Rosa MariaAuthorFigueras-Roca MCorresponding AuthorSala-Puigdollers AAuthorZarranz-Ventura JAuthorAlforja SAuthorMolins BAuthorAdan AAuthor
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Anatomic Response to Intravitreal Dexamethasone Implant and Baseline Aqueous Humor Cytokine Levels in Diabetic Macular Edema

Publicated to:Investigative Ophthalmology & Visual Science. 60 (5): 1336-1343 - 2019-04-01 60(5), DOI: 10.1167/iovs.18-26215

Authors: Figueras-Roca, Marc; Sala-Puigdollers, Anna; Zarranz-Ventura, Javier; Alba-Linero, Carmen; Alforja, Socorro; Esquinas, Cristina; Molins, Blanca; Adan, Alfredo

Affiliations

August Pi i Sunyer Biomed Res Inst IDIBAPS, Barcelona, Spain - Author
Hosp Clin Barcelona, Inst Clin Oftalmol ICOF, Sabino de Arana 1, Barcelona 08028, Spain - Author
Hosp Univ Vall dHebron, Resp Dept, Barcelona, Spain - Author
Hospital Clinic Barcelona - Author
Hospital Universitari Vall d'Hebron - Author
Institut d'Investigacions Biomèdiques August Pi i Sunyer - IDIBAPS - Author
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Abstract

Purpose: To determine whether baseline cytokine aqueous humor (AH) levels are associated with diabetic macular edema (DME) anatomic response to dexamethasone intravitreal implant (DEX) injection. Methods: This was a prospective cohort study of DME cases receiving DEX treatment. Seventy patients were recruited with center-involving DME with spectral-domain (SD) optical coherence tomography (OCT) detection of central macular thickness (CMT) ≥300 μm on macular cube 518 × 128-μm scan protocol (Cirrus SD-OCT). DEX injection and anterior chamber tap to obtain an AH sample were performed at the same time. Multiplex immunoassay was carried out for interleukin (IL)-1β, IL-3, IL-6, IL-8, IL-10; monocyte chemoattractant protein (MCP)-1; interferon gamma-induced protein (IP)-10; tumor necrosis factor (TNF)-α; and vascular endothelial growth factor (VEGF). A follow-up visit and OCT exam were undertaken 6 to 8 weeks afterward. The association between AH cytokine baseline levels and change in CMT and macular volume (MV) was defined as main outcome measure. Results: Multivariate linear regression analysis showed a higher decrease in MV to be associated (Rs of 0.512) with four baseline items: higher MCP-1 (β = -0.4; P = 0.028), higher CMT (β = -0.003; P = 0.024), decreased visual acuity (β = -0.7; P = 0.040), and a diffuse retinal thickening (DRT) OCT pattern (β = -1.3; P < 0.001). Logistic regression found DRT also to be associated with higher odds of a good MV response (odds ratio, 31.96; 95% confidence interval [CI] 7.11-143.72; P < 0.001). Conclusions: Even though visual acuity response and anatomic effect are not always correlated in DME, we found that baseline elevated MCP-1 AH levels and DRT pattern were biomarkers that predicted a future favorable anatomic response to DEX.

Keywords
bevacizumabdiabetic macular edemaeyesintravitreal dexamethasonepatternsranibizumabretinopathyvegfAgedAged, 80 and overAqueous humorCytokineCytokinesDexamethasoneDiabetic macular edemaDiabetic retinopathyDisease severityFemaleGlucocorticoidsHumansIntravitreal dexamethasoneIntravitreal injectionsMacular edemaMaleMiddle agedMultivariate analysisProspective studiesVisual acuity

Quality index

Bibliometric impact. Analysis of the contribution and dissemination channel

The work has been published in the journal Investigative Ophthalmology & Visual Science due to its progression and the good impact it has achieved in recent years, according to the agency WoS (JCR), it has become a reference in its field. In the year of publication of the work, 2019, it was in position 10/60, thus managing to position itself as a Q1 (Primer Cuartil), in the category Ophthalmology.

From a relative perspective, and based on the normalized impact indicator calculated from World Citations provided by WoS (ESI, Clarivate), it yields a value for the citation normalization relative to the expected citation rate of: 2.12. This indicates that, compared to works in the same discipline and in the same year of publication, it ranks as a work cited above average. (source consulted: ESI Nov 14, 2024)

This information is reinforced by other indicators of the same type, which, although dynamic over time and dependent on the set of average global citations at the time of their calculation, consistently position the work at some point among the top 50% most cited in its field:

  • Weighted Average of Normalized Impact by the Scopus agency: 2.66 (source consulted: FECYT Feb 2024)
  • Field Citation Ratio (FCR) from Dimensions: 8.13 (source consulted: Dimensions May 2025)

Specifically, and according to different indexing agencies, this work has accumulated citations as of 2025-05-03, the following number of citations:

  • WoS: 23
  • Scopus: 29
  • Europe PMC: 11
  • OpenCitations: 24
Impact and social visibility

From the perspective of influence or social adoption, and based on metrics associated with mentions and interactions provided by agencies specializing in calculating the so-called "Alternative or Social Metrics," we can highlight as of 2025-05-03:

  • The use, from an academic perspective evidenced by the Altmetric agency indicator referring to aggregations made by the personal bibliographic manager Mendeley, gives us a total of: 49.
  • The use of this contribution in bookmarks, code forks, additions to favorite lists for recurrent reading, as well as general views, indicates that someone is using the publication as a basis for their current work. This may be a notable indicator of future more formal and academic citations. This claim is supported by the result of the "Capture" indicator, which yields a total of: 48 (PlumX).

With a more dissemination-oriented intent and targeting more general audiences, we can observe other more global scores such as:

  • The Total Score from Altmetric: 1.5.
  • The number of mentions on the social network X (formerly Twitter): 3 (Altmetric).

It is essential to present evidence supporting full alignment with institutional principles and guidelines on Open Science and the Conservation and Dissemination of Intellectual Heritage. A clear example of this is:

  • The work has been submitted to a journal whose editorial policy allows open Open Access publication.
Leadership analysis of institutional authors

There is a significant leadership presence as some of the institution’s authors appear as the first or last signer, detailed as follows: First Author (Figueras Roca, Marc) and Last Author (Adán Civera, Alfredo).

the author responsible for correspondence tasks has been Figueras Roca, Marc.