June 2015
Volume 56, Issue 7
Free
ARVO Annual Meeting Abstract  |   June 2015
Predictive power of retinal layer responses to intravitreal ranibizumab treatment for diabetic macular edema
Author Affiliations & Notes
  • Andreas Ebneter
    Department of Ophthalmology, University of Bern, Bern, Switzerland
  • Abhishek Jain
    Department of Ophthalmology, University of Bern, Bern, Switzerland
  • Sebastian Wolf
    Department of Ophthalmology, University of Bern, Bern, Switzerland
  • Martin Sebastian Zinkernagel
    Department of Ophthalmology, University of Bern, Bern, Switzerland
  • Footnotes
    Commercial Relationships Andreas Ebneter, Bayer (R); Abhishek Jain, None; Sebastian Wolf, Bayer (C), Heidelberg Engineering (C), Heidelberg Engineering (F), Novartis (C), Optos Plc (C), Optos Plc (F), Zeiss (C); Martin Zinkernagel, Bayer (C), Heidelberg Engineering (F), Novartis (C)
  • Footnotes
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Investigative Ophthalmology & Visual Science June 2015, Vol.56, 5915. doi:
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    • Get Citation

      Andreas Ebneter, Abhishek Jain, Sebastian Wolf, Martin Sebastian Zinkernagel; Predictive power of retinal layer responses to intravitreal ranibizumab treatment for diabetic macular edema. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):5915.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract
 
Purpose
 

Indicators forecasting benefit from intravitreal anti vascular endothelial growth factor treatment for diabetic macular edema are lacking. We described the thickness change of individual retinal layers in eyes treated with ranibizumab as per RESOLVE protocol, and investigated the predictive value of individual layer responses on the 1-year (1y) visual acuity outcome.

 
Methods
 

Retrospective interventional case series including 33 eyes of 33 patients. Retinal layers were segmented on high-resolution optical coherence tomography scans (Heidelberg Spectralis®) at baseline and 1y using automated software (Heidelberg Eye Explorer) with manual correction if needed. Layer thickness changes and other parameters were analyzed using correlation matrices. A model predicting final visual acuity was built using multiple linear regression.

 
Results
 

The only significant layer thickness change was observed in the inner ring for the inner plexiform layer (Image 1). The correlation matrices showed a similar pattern for inner and outer ring of the standard ETDRS grid (Image 2). Thickness changes in the outer plexiform, the outer and the inner nuclear layers were significant factors in the multiple linear regression model predicting 1y visual acuity.

 
Conclusions
 

A differential response of individual retinal layers was observed in diabetic macular edema treated with ranibizumab. Analysis of individual layer responses to initial treatment might be useful to predict treatment benefit. Further prospective studies are needed to determine suitable time points for imaging.  

 
Representative image at A1) baseline (BL) and A2) 1 year after treatment initiation (1y). Individual layer thickness for the B1) inner ring (IR) and B2) outer ring (OR) of the standard ETDRS grid. [ *< 0.05; t-test]
 
Representative image at A1) baseline (BL) and A2) 1 year after treatment initiation (1y). Individual layer thickness for the B1) inner ring (IR) and B2) outer ring (OR) of the standard ETDRS grid. [ *< 0.05; t-test]
 
 
Correlation matrix for C1) inner ring and C2) outer ring of standard ETDRS grid: Best-corrected visual acuity at 1y (Final_VA), BL (VA_BL) and difference from BL (Diff_VA), number of IVT injections (IVTs), presence of posterior vitreous detachment (PVD), central retina thickness at BL (CRT_BL), decrease of thickness from BL for whole retina (total), ganglion cell layer (GCL), retinal nerve fiber layer (RNFL), inner plexiform layer (IPL), inner nuclear layer (INL), outer plexiform layer (OPL), outer nuclear layer (ONL).
 
Correlation matrix for C1) inner ring and C2) outer ring of standard ETDRS grid: Best-corrected visual acuity at 1y (Final_VA), BL (VA_BL) and difference from BL (Diff_VA), number of IVT injections (IVTs), presence of posterior vitreous detachment (PVD), central retina thickness at BL (CRT_BL), decrease of thickness from BL for whole retina (total), ganglion cell layer (GCL), retinal nerve fiber layer (RNFL), inner plexiform layer (IPL), inner nuclear layer (INL), outer plexiform layer (OPL), outer nuclear layer (ONL).

 
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