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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)
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.
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.
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.
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.
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