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Young Joo Cho, Dong Hyun Lee, Min Kim, Hyoung Jun Koh; Association between OCT findings and response to treatment in diabetic macular edema. Invest. Ophthalmol. Vis. Sci. 2013;54(15):2408.
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© ARVO (1962-2015); The Authors (2016-present)
To compare the effect of intravitreal Bevacizumab injection (IVB) and posterior subtenon triamcinolone injection (PSTI) according to OCT patterns in patients with diabetic macula edema.
We retrospectively reviewed 46 eyes of 35 patients with DME who were treated with IVB or PSTI. Using OCT findings, the eyes were categorized into 2 groups based on the presence or absence of subretinal fluid (SRF) under the macula within 500 um of the fovea. In each group, the eyes were divided into 2 subgroups according to treatment received, either IVB or PSTI, respectively. Central macular thickness (CMT), the distance from retinal pigment epithelium(RPE) to external limiting membrane(ELM) and the distance from RPE to internal limiting membrane(ILM) were measured at pre-treatment, 1 month, and 3 month post-treatment.
In the eyes without SRF, PSTI was more effective in CMT reduction than IVB (20% vs 3%, p = 0.015, Mann-Whitney U test). Resolution of intraretinal edema(the distance from ELM to ILM) was significantly higher in PSTI group than that in IVB group (29% vs 12%, p = 0.03, Mann-Whitney U test). In the eyes with SRF, IVB group achieved greater reduction of CMT compared to PSTI group, but the difference was not significant (33% vs 16%, p = 0.236, Mann-Whitney U test). The degree of SRF reduction(distance from RPE to ELM) was higher in IVB group than PSTI group, but the difference was only marginally significant (43% vs 19%, p = 0.093, Mann-Whitney U test).
DME without SRF was more responsive to PSTI than IVB via the improvement of intraretinal edema. Classification of DME based on OCT findings might be useful for guiding more effective treatment.
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