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Jeffrey Eng, Nathan Lowry, Rivka Strelnikov, Thomas A Ciulla, Michael S Ip; Vertical Transect Analysis of Optical Coherence Tomography Images in Patients Treated for Diabetic Macular Edema. Invest. Ophthalmol. Vis. Sci. 2021;62(8):1786.
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© ARVO (1962-2015); The Authors (2016-present)
Diabetic macular edema (DME) is a common cause of vision loss among diabetics. Optical coherence tomography (OCT) remains a vital component in the evaluation and management of diabetic macular edema. We sought to evaluate whether Draper’s novel vertical transect analysis (VTA), when applied to OCT images in eyes with DME, might accurately predict treatment endpoints.
A post-hoc analysis was performed on OCT images and clinical data from the TYBEE clinical trial. TYBEE is a multicenter, randomized, masked clinical trial to evaluate the safety and efficacy of suprachoroidal triamcinolone acetonide along with intravitreal Eylea compared with Eylea monotherapy in patients with DME and without prior pharmacologic treatment. Best corrected visual acuity (BCVA) was determined at the clinical sites participating in the clinical trial. OCT central subfield thickness (CST) and Diabetic Retinopathy Severity Score (DRSS) were determined at a central Reading Center. OCT images were processed by automatic segmentation then manually adding a line for the fovea. The vertical transect analysis was then performed on baseline and post-treatment OCT images (both processed and unprocessed) with regression analysis.
BCVA significantly correlated with VTA applied to processed baseline plus post-treatment OCT images (P=0.044) and with VTA applied to processed baseline OCT images (P=0.038). The change in visual acuity from baseline to post-treatment did not significantly correlate with VTA applied to unprocessed baseline OCT images (P=0.086) or with processed baseline OCT images (P=0.300). The CST significantly correlated with VTA applied to unprocessed (P=0.048) and processed (P=1.87e-4) baseline plus post-treatment OCT images and to processed (P=0.007) baseline OCT images. However, the change in CST from baseline to post-treatment did not significantly correlate with VTA applied to both unprocessed (P=0.629) and processed (P=0.412) baseline OCT images. The DRSS and change in DRSS from baseline to post-treatment did not significantly correlate with VTA applied to any OCT images.
There was correlation between BCVA/CST and VTA but no correlation between DRSS and VTA. With more study, VTA has the potential to be a powerful clinical and research tool to predict clinical endpoints in patients undergoing treatment for diabetic macular edema.
This is a 2021 ARVO Annual Meeting abstract.
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