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Miguel Nicolas Nicolás Cruz Pimentel, Daniel Mesa Rosselló, Audrey Juan, Nassim Abreu Arbaje, Yazmín Baéz, Jeannette Domínguez, Juan F Batlle Pichardo, Lihteh Wu; The SD-OCT and OCT-A profile of DRIL extension in cases of diabetic macular edema refractory to anti-VEGF. Invest. Ophthalmol. Vis. Sci. 2018;59(9):402.
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To correlate the extent of disruption of the inner layers of the retina with visual acuity, as well as evaluate the relation between DRIL extent and FAZ size in OCT-A.
A series of intervention cases, in which the patients who met the selection criteria were included. All patients included in the study agreed to sign an informed consent, this study was carried out following the principles of ethics of the Helsinski Declaration. All images were taken by Cirrus® SD-OCT by a single operator. The variables measured were: visual acuity, foveal thickness central subfield, disorganization of the inner layers of the retina (DRIL). In addition, an evaluation of the FAZ in the superficial and deep plexus was performed using OCT-A in a subgroup of 7 eyes, images were taken using Angioplex® in Cirrus® SD-OCT, a FAZ measurement was performed using the software Image J (Figure 1). A normal distribution of the sample was found, therefore, the mean and the Pearson correlation tests were used to study the variables
A total of 21 eyes were analyzed, a mean value 0.64 in the logMAR scale of best corrected visual acuity was obtained, a mean extension of the DRIL was 1167.28 microns (Figure 2), a mean central foveal thickness of 480 microns. A positive Pearson correlation was found between the horizontal extension of the DRIL in microns and the visual acuity (p 0.019).We also found a positive correlation between central foveal thickness and the extension of DRIL in microns (p 0.026). A Pearson correlation was performed correlation between DRIL extension and the size of the FAZ in both superficial and deep plexus, no statistical correlation was found. The FAZ mean value in the superficial plexus was 414.2 microns and in the deep plexus was 683.2 microns
Our results suggests that there is an inversely proportional relationship between DRIL and visual acuity in patients refractory to treatment with Bevacizumab.We suggest the assessment and quantification of DRIL before starting and during treatment with anti angiogenic agents. According to our findings there is not relationship between the DRIL extension and the FAZ extension, however patients refractory to treatment may have increase FAZ in the deep plexus.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
FAZ measurement on superficial plexus using Image J software.
DRIL extension measurement in a patient non responder to multiple anti VEGF injections
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