Abstract
Purpose: :
Although many publications had demonstrated the efficacy of triamcinolone acetonide (TA) for diabetic macular edema (DME), it remains ill-defined what factors can predict the clinical course after TA treatment. We herein investigated the clinical relevance of OCT reflectivity of cystoid spaces delineated by spectral-domain optical coherence tomography (SD-OCT) in eyes treated with TA for DME.
Methods: :
Consecutive series of 49 eyes from 43 patients suffering from DME with cystoid spaces on the fovea underwent intravitreal or sub-Tenon’s administration of TA. We examined the average reflectivity in the contents of cystoid spaces within 500µm centered on the fovea depicted by SD-OCT (Spectralis OCT; Heidelberg Engineering) and logMAR and average foveal thickness (FT) within central 1mm. We evaluated the association between OCT reflectivity in the cystoid spaces at baseline and the course of logMAR.
Results: :
OCT reflectivity of cystoid spaces was significantly increased at both 1 and 6 months after TA treatment (15.0±13.8, 23.4±17.4, 23.4±17.8 at baseline, 1 month, 6 months respectively; p=0.005 and p<0.001, respectively). The OCT reflectivity at baseline, independent of preoperative logMAR and FT, was negatively associated with VA deterioration from 1 month to 6 months after TA treatment (p=0.015, r=0.346), but not with either logMAR at each time point or VA changes from baseline to 1 or 6 months. Preoperative logMAR was positively correlated to logMAR at 1 and 6 months (p<0.001, r=0.917; p<0.001, r=0.875) and VA improvement at 1 month (p=0.015, r=0.347), compared to no association with VA deterioration from 1 to 6 months. Baseline FT showed positive association with logMAR at 1 and 6 months (p=0.031, r=0.312; p=0.009, r=0.380), but not with VA changes.
Conclusions: :
These data suggest that baseline OCT reflectivity of cystoid spaces may predict VA deterioration from 1 month to 6 months after TA treatment for DME, compared to preoperative VA or macular thickness.
Keywords: diabetic retinopathy • diabetes