Abstract
Purpose :
to report a longitudinal analysis of specific optical coherence tomography (OCT) features in eyes with diabetic macular edema (DME) treated with anti-VEGF.
Methods :
Design: retrospective interventional case series
Population: a total of 170 eyes of 129 consecutive patients with center-involving DME treated between August 2008 and June 2015 with 3 monthly intravitreal anti-VEGF - with or without prompt or deferred laser- followed by PRN re-treatment.
Methods: eyes were divided into one of the four following categories based on whether they had a sustained reduction in central macular thickness (CMT) of at least 20%: early responder and consistent (group 1), late responder (group 2), early but inconsistent (group 3), non-responder (group 4). The following OCT biomarkers were evaluated at baseline, after the loading phase and at DME recurrences: subfoveal neuroretinal detachment (SND), number of hyperreflective retinal spots (HRS), integrity of external limiting membrane (ELM), CMT, central retinal thickness (CRT). Changes in OCT biomarkers were evaluated throughout the follow-up (FU) period. Correlations between OCT biomarkers were determined both at baseline and over the FU period.
Results :
At baseline the number of HRS (p-value: 0.001) and prevalence of SND (p-value: 0.0002) were significantly higher in group 3 and 4 compared to group 1 and 2. After the loading phase the number of HRS, CMT, CRT and prevalence of SND significantly decreased in all groups (p-value<0.0001). The presence of SND was associated with a high number of HRS both at baseline and during the FU (p-value<0.0001). A significant direct correlation was found between baseline number of HRS/presence of SND and those found at the time of the recurrences (p-value<0.0001).
Conclusions :
in the study population, presence of SND and high number of HRS were more frequent in eyes with a suboptimal response to treatment. Recurrent DME was found to show similar OCT features to those exibithed at baseline. These findings suggest that SND and HRS might characterize a specific pattern of DME. Additional studies on OCT biomarkers in DME are required to define their pathophysiologic implications and their role as outcome predictors.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.