Twelve-month Outcomes of Ellipsoid Zone and External Limiting Membrane Status after Intravitreal Aflibercept in Diabetic Macular Edema

Abstract

Purpose : We reported previously that ellipsoid zone (EZ) and external limiting membrane (ELM) status once deteriorated after pars plana vitrectomy in patients with diabetic macular edema (DME), then EZ and visual acuity (VA) improved up to 24 months though ELM recovered but did not improve (Ophthalmology Retina 2017). Recently anti-vascular endothelial growth factor agents have been the mainstay of treatment for DME, then we studied if intravitreal aflibercept (IVA) effects on the EZ and ELM status in optical coherence tomography (OCT) images of patients with DME.

Methods : We retrospectively reviewed the spectral-domain OCT images of 58 eyes from 43 cases with DME who were treated with IVA (3 monthly induction with pro re nata) and evaluated various factors such as the status of EZ and ELM, central retinal thickness (CRT) and VA up to 12 months. We used a percentage disruption to evaluate the status of EZ and ELM.

Results : logMAR VA was 0.371 at baseline and improved to 0. 242 at 3 months, 0.268 at 6 months and 0.262 at 12 months (P<0.05) after IVA. CRT was 511.2 μm at baseline, decreased to 336.3 μm at 3 months, 373.8 μm at 6 months and 360.3 μm at 12 months (P<0.05) after IVA. The percentage disruption of EZ was 20.5 % at baseline and did not change significantly at 3 months (18.7%, P=0.16), then decreased to 13.9% at 6 months and 15.6% at 12 months significantly (P<0.05). The percentage disruption of ELM was 11.7% at baseline, and did not change significantly until 12 months (10.4%, P=0.934).

Conclusions : The status of ELM did not change after IVA for DME, whereas the disruption of EZ gradually decreased, then improved significantly after 6 and 12 months.

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