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Deepti Saini, Joanna Olson, Ingrid U Scott, Esther M Bowie; Choroidal thickness before and after intravitreal anti-VEGF therapy in patients with diabetic macular edema.. Invest. Ophthalmol. Vis. Sci. 2014;55(13):1749.
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o investigate if intravitreal anti-vascular endothelial growth factor (anti-VEGF) therapy is associated with a change in choroidal thickness in patients with diabetic macular edema (DME).
Prospective case series of patients treated at Penn State Hershey Eye Center with intravitreal anti-VEGF therapy for DME. Participants were consented according to IRB protocol. Exclusion criteria include patients who received intravitreal anti-VEGF injection(s), photocoagulation to the retina or vitrectomy within the prior three months. Choroidal thickness measurement on spectral domain optical coherence tomography (SDOCT) was performed using enhanced depth imaging (EDI) at baseline and monthly by two readers. The Cirrus linear measurement tool was used to measure choroidal thickness from the outer edge of the hyperreflective retinal pigment epithelium (RPE) to the inner sclera at 500 micron intervals temporal and nasal to the fovea up to 3000 microns. Statistical analysis was performed on the average thickness measurements from the two readers using paired T-test.
To date, 13 patients have been enrolled into the study. Of these 13 patients, pre- and post-anti-VEGF SDOCT EDI results are available for 7 eyes of 7 patients. Five of the 7 patients (71%) are Caucasian and 6/7 (86%) are men. All of the patients have a history of type 2 diabetes mellitus and all were treated with intravitreal ranibuzumab 0.3mg. Among the 7 study eyes, for each of the 6 locations of choroidal thickness measurement except for at the fovea, there was a decrease from baseline in the mean choroidal thickness at 1 month post-injection (range of reduction in thickness: 2.5 to 48.5 microns).
Intravitreal anti-VEGF therapy may be associated with a decrease in choroidal thickness in patients with DME. Larger prospective studies with longer follow-up are warranted to investigate the potential effects of anti-VEGF therapy on choroidal thickness in patients with DME.
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