ANALYSIS OF VITREOUS SAMPLES TO GUIDE TREATMENT
A method of guiding medical treatment of patients receiving an intravitreal injection are described. The method includes obtaining a vitreous sample from a subject receiving an intravitreal injection first treatment, determining the biomarker signature of the sample, reporting the biomarker signature of the sample, and changing the method of treatment to a second treatment if the biomarker signature indicates that use of the second treatment will have a preferable outcome.
1 . A method of guiding medical treatment comprising: analyzing a vitreous sample from a subject receiving an intravitreal injection first treatment, determining the biomarker signature of the sample, reporting the biomarker signature of the sample, and generating a recommendation to change the method of treatment to a second treatment if the biomarker signature indicates that use of the second treatment will have a preferable outcome.
2 . The method of claim 1 , wherein the method further comprises obtaining a vitreous sample from the subject.
3 . The method of claim 1 , further comprising administering the second method of treatment.
4 . The method of claim 1 , further comprising the step of delivering the sample to a laboratory.
5 . The method of claim 1 , wherein the biomarker signature of the sample is reported before the patient's next scheduled visit.
6 . The method of claim 5 , wherein the next scheduled visit is at least 2 weeks after the vitreous sample is obtained.
7 . The method of claim 1 , wherein the biomarker signature is a protein signature.
8 . The method of claim 7 , wherein the protein signature is determined using an immunoassay.
9 . The method of claim 1 , wherein the protein signature comprises a weighted sum of the concentrations of a plurality of proteins.
10 . The method of claim 7 , wherein the protein signature comprises angiogenic factors.
11 . The method of claim 10 , wherein the angiogenic factors comprise vascular endothelial growth factor (VEGF), placental growth factor (PIGF), and/or angiopoietin 2 (Ang2).
12 . The method of claim 7 , wherein the protein signature comprises inflammatory factors.
13 . The method of claim 12 , wherein the inflammatory factors comprise interleukin-8 (IL-8) and/or interleukin-6 (IL-6).
14 . The method of claim 7 , wherein the protein signature comprises proteins that are the known targets of ophthalmic drugs.
15 . The method of claim 14 , wherein the ophthalmic drugs are antibody-based drugs that specifically bind to the proteins.
16 . The method of claim 7 , wherein the proteins are weighted according to an action profile of the first treatment.
17 . The method of claim 1 , wherein the biomarkers are weighted according to an action profile of the second treatment.
18 . The method of claim 1 , wherein the biomarker signature is compared to a population distribution.
19 . The method of claim 18 wherein the population distribution is divided into patients who are responders or non-responders to the first treatment.
20 . The method of claim 1 , wherein the first treatment comprises administration of an anti-angiogenic agent.
21 . The method of claim 1 , wherein the first treatment comprises administration of an antibiotic.
22 . The method of claim 1 , wherein the second treatment comprises administration of an anti-inflammatory agent.
23 . The method of claim 1 , wherein the biomarker signature includes bacterial antigens.
24 . The method of claim 1 , wherein the biomarker signature includes viral RNA.
25 . The method of claim 1 , wherein the biomarker signature is determined and reported a plurality of times.
26 . The method of claim 1 , wherein a preferable outcome is indicated by a normalized protein signature.
27 . The method of claim 1 , wherein the vitreous sample is obtained using a device that is configured to inject a volume into the eye having the same volume as the sample being obtained.
28 . The method of claim 27 , wherein the device is a double-barreled syringe comprising an injectant chamber and a sample chamber.