Abstract
Purpose: :
To classify the baseline patterns of optical coherence tomography (OCT) for DME and to evaluate the correlation of OCT pattern type with the pre- and post-treatment BCVA and analyze changes in OCT patterns with emphasis on macular subfields after treatment with varying frequency of Intravitreal pegaptanib sodium injections (IVP) over 24 week period.
Methods: :
Charts of 9 patients (9 eyes, 5 treated with IVP 0.3mg every 4 weeks (Q4 arm), and 4 treated every 6 weeks (Q6 arm)) were retrospectively reviewed. Stratus OCT (Retinal Map Analysis Report) were analyzed pre- and post-treatment using a standard protocol to obtain the average thickness in every subfield (central, superior, temporal, inferior and nasal). We classified the OCT pattern present and documented the changes in OCT patterns by subfield. We then correlated changes in pre- and post-treatment BCVA with changes in these subfields.
Results: :
OCT patterns observed were: Diffuse retinal thickness in 100% of OCT’s, cystoid macular edema in 81.79%, serous retinal detachment in 21.91%, posterior hyaloidal traction without tractional retinal detachment in 9.25%. The patients in the Q4 arm had a mean baseline BCVA of 20/68 and a mean final BCVA of 20/59. The average retinal thickness in all subfields at baseline was 351.79µm, and 331.90µm at week 24.The patients in the Q6 arm had a mean baseline BCVA of 20/80 and mean BCVA of 20/72 at week 24. The average retinal thickness in all subfields at baseline was 394.66µm and post treatment of 385.69µm. The subfields most affected were central (with a mean drop of 71.28µm in the Q4 arm and 84.48µm in the Q6 arm), temporal (with a mean drop of 40.78µm in the Q4 arm and 50.88µm in the Q6 arm), and inferior (with a mean drop of 35.54µm in the Q4 arm and 67.02µm in the Q6 arm).
Conclusions: :
Retinal thickness due to DME was present to a higher extent in the same subfields in both arms (central, temporal and inferior). Although mean retinal thickness and BCVA improved after treatment with IVP in all 9 patients, OCT DME patterns in the most affected subfields did not change subsequently. There was also no correlation between OCT DME patterns and the mean BCVA pre- and post-treatment.
Keywords: diabetic retinopathy • edema • injection