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Zubir Rentiya, Yasir Sepah, Mohamed Ibrahim, Mohammad Sadiq, Muhammad Hassan, Saleema Kherani, Hyun Soo Jang, Raafay Sophie, Diana Do, Quan Dong Nguyen; Comparison of retinal layer thickness of normal eyes and eyes with diabetic macular edema receiving ranibizumab. Invest. Ophthalmol. Vis. Sci. 2013;54(15):3608.
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© ARVO (1962-2015); The Authors (2016-present)
To determine changes in thickness of individual retinal layers in eyes with diabetic macular edema (DME), which have been treated with ranibizumab (RBZ) and have shown resolution of edema.
Spectral-domain optical coherence tomography (SD-OCT) scans were acquired from 30 eyes (30 patients) with DME that have been treated with RBZ and shown resolution of edema evidenced by absence of fluid in the central 1.5 mm above and below the foveal center on OCT. A high-resolution horizontal line scan passing through the fovea was acquired from one eye of each patient using Spectralis HRA+OCT™. Retinal layers were segmented to allow calculation of average thickness of retinal pigment epithelium (RPE), photoreceptor layer (PRL), bipolar cell layer (BPL), and the combined ganglion cell and nerve fiber layers (GCL-NFL) along the 5 mm line centered on the fovea (C). Spatial changes in the thicknesses of the layers were assessed in 0.5mm increments. The measured values were compared to those from 50 normal eyes with no known retinal disease reported by Ibrahim et al. in 2012.
Full retinal thickness (FRT) at C was thinner than normal (p<0.05) in 7 patients (23.3%). GCL-NFL was significantly thinner than normal (p<0.05) in 8 patients (26.7%); RPE was thinner in 8 patients (26.7%); BPL was thinner in 1 patient (3.3%) and thicker in 14 patients (46.7%); PRL was thinner in 6 patients (20%) at C (p<0.05). 10 other patients (33.3%) showed significant focal thinning in subfields other than C. The average thickness of the photoreceptors layer was significantly thinner than normal (p<0.05) in the subfields 0.5mm on each side of the foveal center. Meanwhile, the bipolar cell layer was significantly thicker in the same subfields. Additional results are illustrated in Table.
Segmentation of OCT scans has revealed statistically significant changes in the thickness of individual retinal layers in DME patients, including PRL, BPL, RPE, and GCL-NFL. In the central 1mm on each side of the fovea, the PRL was thinner than normal. Meanwhile, bipolar cells layers in eyes with DME were thicker than in normal eyes in the same area, which may suggest the presence of residual fluid in the BPL, not detected without segmentation of OCT scans.
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