Development of a 1‐year risk‐prediction nomogram for good functional response with anti‐VEGF agents in naive diabetic macular oedema

Abstract

Purpose To develop a risk‐prediction nomogram based on baseline variables for good functional response during the 1st year of treatment with anti‐VEGF agents in naive diabetic macular oedema (DME). Methods This retrospective study included patients presenting naive‐DME treated with anti‐VEGF therapy at Dijon University Hospital (France) between 1 February 2012 and 31 March 2015 (derivation cohort). We studied baseline variables that had significant associations with a good functional response to anti‐VEGF agents during the 1st year of treatment. We used a program to generate a nomogram based on a binary logistic regression predictive model. Then, this nomogram was tested on data from a separate cohort of naive‐DME patients from a multicenter study involving 20 French ophthalmologic centres between January 2014 and June 2015 (validation cohort). Results Age, baseline BCVA and ellipsoid zone integrity on spectral‐domain optical coherence tomography (SD‐OCT) are functional prognostic factors and were used to build a nomogram. The nomogram showed excellent discrimination for good functional responders (area under the curve (AUC) = 0.906, 95% confidence interval (95% CI) = [0.849–0.964], p = 0.004). The discriminative power of this nomogram was tested on the validation cohort data, demonstrating good discrimination of good functional responders (AUC = 0.942, 95% CI = [0.898–0.986], p < 0.001). Conclusion This nomogram provides a useful estimation of a good functional response in naive‐DME patients treated with anti‐VEGF agents.