July 2018
Volume 59, Issue 9
Open Access
ARVO Annual Meeting Abstract  |   July 2018
Association between hyperreflective foci in the outer retinal layers and functional efficacy of ranibizumab for diabetic macular edema
Author Affiliations & Notes
  • Tomoaki Murakami
    Ophthalmology & Visual Sciences, Kyoto Univ Grad Sch of Med, Kyoto, KYOTO, Japan
  • Kiyoshi Suzuma
    Ophthalmology & Visual Sciences, Kyoto Univ Grad Sch of Med, Kyoto, KYOTO, Japan
  • Tatsuya Yoshitake
    Ophthalmology & Visual Sciences, Kyoto Univ Grad Sch of Med, Kyoto, KYOTO, Japan
  • Hideo Nakanishi
    Ophthalmology & Visual Sciences, Kyoto Univ Grad Sch of Med, Kyoto, KYOTO, Japan
  • Masahiro Fujimoto
    Ophthalmology & Visual Sciences, Kyoto Univ Grad Sch of Med, Kyoto, KYOTO, Japan
  • Maho Oishi
    Ophthalmology & Visual Sciences, Kyoto Univ Grad Sch of Med, Kyoto, KYOTO, Japan
  • Akitaka Tsujikawa
    Ophthalmology & Visual Sciences, Kyoto Univ Grad Sch of Med, Kyoto, KYOTO, Japan
Investigative Ophthalmology & Visual Science July 2018, Vol.59, 3595. doi:
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    • Get Citation

      Tomoaki Murakami, Kiyoshi Suzuma, Tatsuya Yoshitake, Hideo Nakanishi, Masahiro Fujimoto, Maho Oishi, Akitaka Tsujikawa; Association between hyperreflective foci in the outer retinal layers and functional efficacy of ranibizumab for diabetic macular edema. Invest. Ophthalmol. Vis. Sci. 2018;59(9):3595.

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

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Abstract

Purpose : Diabetic hyperreflective foci on spectral-domain optical coherence tomography (SD-OCT) were documented as the precursors of hard exudates or lipid-laden macrophages. In this study, we investigated the association of hyperreflective foci in the outer retinal layers with the functional outcomes in eyes treated with intravitreal ranibizumab (IVR) for diabetic macular edema (DME).

Methods : We retrospectively reviewed 58 eyes of 54 patients who received 3 monthly dosing followed by as-needed IVR injections for center-involved DME for 12 months or more. Retinal sectional images were obtained using SD-OCT (Spectralis OCT, Heidelberg Engineering), followed by the evaluation of hyperreflective foci in the outer retinal layers at the fovea. We then analyzed the differences of the logarithm of the minimum angle of resolution visual acuity (logMAR VA) between eyes with and without hyperreflective foci in the outer retinal layers at 12 months.

Results : LogMAR was significantly improved from 0.340±0.262 to 0.208±0.246 (P<0.001) in all 58 eyes, and SD-OCT delineated hyperreflective foci in outer retinal layers in 31 eyes at baseline and in 22 eyes at 12 months. At baseline, eyes with hyperreflective foci in outer retinal layers had poorer logMAR VA than those without such foci (0.404±0.310 vs. 0.266±0.172; P=0.047), whereas there was no difference in logMAR VA at 12 months. VA improvement was greater in eyes with the hyperreflective foci than in those without such foci (0.199±0.120 vs. 0.055±0.140; P<0.001), and the status of the ellipsoid zone of photoreceptors was also improved more in eyes with such foci (P<0.001). Multivariate analyses confirmed the association between the hyperreflective foci at baseline and VA improvement at 12months.

Conclusions : These data suggest that hyperreflective foci in outer retinal layers at baseline may predict VA improvement in eyes treated with IVR PRN for DME.

This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.

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