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Amy Mehta, Brandon B. Johnson, Pearl Rosenbaum, Jonathan Levine; Correlation of Subfoveal Choroidal Thickness with Change in Central Foveal Thickness and BCVA in Hispanic and Caribbean Patients Treated with Anti-VEGF for Diabetic Macular Edema. Invest. Ophthalmol. Vis. Sci. 2016;57(12):4165. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
To measure change in subfoveal choroidal thickness (SCT) subsequent to anti vascular endothelial growth factor (anti-VEGF) intravitreal injection, and to correlate this with change in best corrected visual acuity (BCVA) and central foveal thickness (CFT). .
A retrospective chart review of 80 consecutive patients (120 eyes) with clinically significant macular edema (CSME) treated with intravitreal Ranibizumab (R), Bevacizumab (B), and/or Aflibercept (A) at the Bronx-Lebanon Hospital Center Eye Clinic between January 2014 - July 2015. The anti-VEGF agent was selected at the discretion of the treating retina specialist. Patients with a remote history of anti-VEGF therapy, ocular laser and incisional surgery (other than cataract extraction), or who had cystoid macular edema secondary to another etiology were excluded. Baseline and post-treatment spectral-domain optical coherence tomography (SD-OCT) measurements of SCT were analyzed and correlated with BCVA and CFT ((minimum follow-up time of 3-months)). Multivariate analysis was performed with respect to age, ethnicity/race, hemoglobin A1c, severity of diabetic retinopathy based on ETDRS stratification, number of injections, anti-VEGF agent administered, and time from baseline to most recent SD-OCT.
A statistically significant increase in mean SCT (B: 30 µm [p <0.05, range: 15-53 µm]; R: 12 µm [p< 0.05, range: 7-14]; A: 40 µm [p <0.05, range: 40-41 µm]), with decrease in mean CFT (B: 37 µm [p <0.04, range: 15-50 µm]; R: 22 µm [p< 0.05, range: 19-25 µm]; A: 40 µm [p<0.05, range: 7-64 µm]) and BCVA improvement (B: 0.54 logMAR; R: 0.34 logMAR; A: 0.3 logMAR) was noted in all three treatment groups.
This data suggests an inverse relationship between SCT and CFT following anti-VEGF treatment in patients with CSME. SCT measurement by SD-OCT may thus be a useful diagnostic adjunct in monitoring the clinical response to anti-VEGF agents. Further, demonstration of a temporal relationship between SCT increase and CFT decrease following injection may support the role of SCT as an early predictor of treatment response.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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