September 2016
Volume 57, Issue 12
Open Access
ARVO Annual Meeting Abstract  |   September 2016
OCT Predictors for BCVA Response to Intravitreal anti-VEGF Treatment in Eyes with Diabetic Macular Edema
Author Affiliations & Notes
  • Ana Rita Santos
    CEC, AIBILI, Coimbra, Portugal
    CORC, AIBILI, Coimbra, Portugal
  • Christian Schwartz
    CORC, AIBILI, Coimbra, Portugal
  • Silvia N Simao
    CEC, AIBILI, Coimbra, Portugal
    CORC, AIBILI, Coimbra, Portugal
  • Miguel Costa
    4C, AIBILI, Coimbra, Portugal
  • Dalila Alves
    4C, AIBILI, Coimbra, Portugal
  • Maria Luisa Ribeiro
    CEC, AIBILI, Coimbra, Portugal
  • Joao Figueira
    CEC, AIBILI, Coimbra, Portugal
    Ophthalmology Department, Coimbra University Hospital, Coimbra, Portugal
  • Jose G Cunha-Vaz
    AIBILI, Coimbra, Portugal
    Faculty of Medicine, University of Coimbra, Coimbra, Portugal
  • Footnotes
    Commercial Relationships   Ana Rita Santos, None; Christian Schwartz, None; Silvia Simao, None; Miguel Costa, None; Dalila Alves, None; Maria Luisa Ribeiro, None; Joao Figueira, None; Jose Cunha-Vaz, Novartis (C)
  • Footnotes
    Support  Novartis Grant
Investigative Ophthalmology & Visual Science September 2016, Vol.57, 2080. doi:
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      Ana Rita Santos, Christian Schwartz, Silvia N Simao, Miguel Costa, Dalila Alves, Maria Luisa Ribeiro, Joao Figueira, Jose G Cunha-Vaz; OCT Predictors for BCVA Response to Intravitreal anti-VEGF Treatment in Eyes with Diabetic Macular Edema. Invest. Ophthalmol. Vis. Sci. 2016;57(12):2080.

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

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Purpose : To determine OCT morphological characteristics that can predict the response to anti-VEGF treatment of Diabetic Macular Edema (DME).

Methods : Seventy-one patients with DME were enrolled in a prospective, observational study, following accepted clinical practice (NCT01947881-CHARTRES). Of these, 67 completed the study. All patients received monthly intravitreal injections of anti-VEGF Lucentis in the first 3 months. All patients underwent BCVA measurements by ETDRS protocol and SD-OCT (Cirrus HD-OCT 5000, Zeiss Meditec) at baseline, months 1, 2, 3 and 6 and Color Fundus Photography (CFP) and Fluorescein Angiography (FA) at baseline and months 3 and 6. The treatment response was characterized in groups according to the increase of BCVA letters: Good Responders (improvement of ≥ 10 letters), Moderate Responders (improvement between 5 letters and 10 letters) and Poor Responders (improvement of < 5 letters or loss of letters). The SD-OCT images were analyzed and graded by an independent Reading Center to obtain a morphological characterization of DME before and after treatment. Central Retinal Thickness (CRT), extension of Disorganization of the Retinal Inner Layers (DRIL), size of intraretinal cystoid spaces and extension of disruption of External Limitant Membrane (ELM), Ellipsoid Zone (EZ) and Retinal Pigment Epithelium (RPE), were quantified in the 1 mm area centered on the fovea.

Results : Twenty-six patients (38.80%) were identified as Good Responders, 19 (28.35%) as Moderate Responders and 22 (32.83%) as Poor Responders. No significant differences regarding BCVA and central retinal thickness (CRT) were found at baseline between the 3 groups (p=0.176 and p=0.573 respectively). Higher values of DRIL area and disruption of external retinal layers at baseline, especially EZ and ELM layers, were significantly correlated with a poor response to treatment ((0.12; CI: 0.02- 0.59; P=0.009) (0.24; CI: 0.07- 0.86; P=0.029) and (0.21; CI: 0.04- 1.20; P=0.079, respectively). A poor response to treatment was also correlated with the presence of larger cystoid spaces in the 1 mm centered on fovea (80.95% of larger cysts in poor responders vs 46.15% in good responders).

Conclusions : Higher values of DRIL area and disruption of external retinal layers, especially damage of the EZ and ELM are good predictors for BCVA response to anti-VEGF therapy in DME.

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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