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Hyeseong Hwang, Ju Byung Chae, Sung Min Hyung, Jae-hyung Kim, Dong Yoon Kim; THE ASSOCIATION BETWEEN HYPERREFLECTIVE DOT ON OCT AND ITS RESPONSE TO INTRAVITREAL BEVACIZUMAB IN MACULAR EDEMA SECONDARY TO DIABETIC RETINOPATHY AND RETIANL VEIN OCCLUSION. Invest. Ophthalmol. Vis. Sci. 2017;58(8):60.
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© ARVO (1962-2015); The Authors (2016-present)
To investigate the association between hyperreflective dots (HRDs) on SD-OCT and its responsiveness to intravitreal bevacizumab (IVB) or dexamethasone implant in eyes with diabetic macular edema (DME) or macular edema due to retinal vein occlusion (RVO).
Retrospective review was conducted on eyes with DME and macular edema due to RVO. Treatment naïve macular edema was initially treated by IVB injection. After 3 consecutive IVB injection, eyes were classified by the treatment response to IVB. Bevacizumab non-responders were treated by dexamethasone implant and were also reclassified by the treatment response to dexamethasone implant. Number of HRDs, BCVA, outer plexiform layer disruptions, ellipsoidal zone defects and external limiting membrane defects were analyzed according to the treatment responsiveness.
72 eyes with DME (54 patients, 40 (55.56 %) bevacizumab responder, 32 (44.44%) bevacizumab non-responder) and 68 eyes with RVO (68 patients, 46 (67.56 %) bevacizumab responder, 22 (32.35 %) bevacizumab non-responder) were include in this study. The number of baseline HRDs in bevacizumab non-responder (15.47 ± 6.26 in DME, 14.23 ± 4.09 in RVO) was significantly more, compared with responder (p=0.008 in DME, p=0.013 in RVO) and did not decrease after IVB injection. Unlike non-responder, baseline HRDs numbers of bevacizumab responder (11.90 ± 4.92 in DME, 11.17 ± 4.83 in RVO) were significantly less and became decrease after IVB injection (p<0.001). Eyes which responded to dexamethasone implant but do not respond to IVB had significantly more numbers of HRDs (21.84 ± 2.67) than those eyes that did not respond (14.20 ± 4.27, p<0.001).
In patients with DME or macular edema due to RVO, the number of HRDs on SD-OCT can be a predictive indicator of the treatment responsiveness to IVB injection or dexamethasone implant. In bevacizumab responder, the number of HRDs on SD-OCT was less. On the contrary to bevacizumab responsiveness, more HRDs were observed in the dexamethasone responder. Therefore, dexamethasone implant might be a primary choice in DME or RVO eyes with many HRDs on SD-OCT.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.
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