Risk factors for recurrence after Conbercept treatment in diabetic macular edema and construction of a risk prediction model

Chen Fengling; Lai Yuxuan; Li Wanchang; Liang Guimei; Mo Yanxia; Chen Fengxian; Chen Xiaolan; Liu Huier; Liu Jiahui; Zhu Yuzhen

doi:10.11986/j.issn.1673-873X.2025.08.12

Abstract：Objective To analyze risk factors for recurrence after Conbercept treatment in patients with diabetic macular ede-ma(DME)and to construct a risk prediction model to inform clinical decision-making.Methods From January 2021 to De-cember 2023,164 DME patients treated with Conbercept at our hospital were included and followed continuously for 12 months after treatment.Patients were grouped by recurrence status into a recurrence group(n=49)and a non-recurrence group(n=115).Multivariable stepwise logistic regression analysis was used to identify factors associated with recurrence after Conbercept,and a nomogram was constructed based on the regression results.The model's predictive value was evalu-ated for recurrence after Conbercept treatment in patients with DME.Results Compared with the non-recurrence group,the recurrence group had significantly higher proportions of patients aged≥60 years,retinal hyperreflective foci,and disor-ganization of the retinal inner layers(DRIL),and had greater pre-treatment foveal central retinal thickness(CRT);addi-tionally,the recurrence group had longer durations of diabetes and DME,and higher fasting blood glucose and glycosylated hemoglobin levels(P＜0.05).Multivariable analysis identified age ≥60 years(OR=1.968,95％CI:1.416-2.735),lon-ger DME duration(OR=2.465,95％CI:1.656-3.669),higher pre-treatment CRT(OR=2.335,95％CI:1.584-3.442),presence of retinal hyperreflective foci(OR=2.492,95％CI:1.671-3.717),and presence of DRIL(OR=3.016,95％CI:1.937-4.697)as risk factors for recurrence after Conbercept treatment(P＜0.05).The nomogram based on these variables showed a concordance index(C-index)of 0.897(95％CI:0.845-0.949).Internal validation indicated good model fit(x2=0.842,P=0.476)and calibration with the calibration curve close to the ideal.The nomogram model predicted an area under the curve(AUC)of 0.905(95％CI:0.853-0.957)for recurrence after Conbercept treatment in DME patients,with a specificity of 68.51％and a sensitivity of 92.74％.Conclusion Age,DME duration,pre-treatment CRT,retinal hyperreflective foci,and DRIL are associated with recurrence after Conbercept treatment in DME patients.The nomogram constructed from these factors demonstrates good predictive performance.