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Thomas S Hwang, kotaro tsuboi, Yukun Guo, JIE WANG, Christina J Flaxel, Steven T Bailey, David Huang, Yali Jia; Automated fluid volume detection is associated with 1-year treatment requirements in eyes with diabetic macular edema. Invest. Ophthalmol. Vis. Sci. 2022;63(7):2524 – F0250.
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© ARVO (1962-2015); The Authors (2016-present)
To assess the relationship between optical coherence tomography angiography (OCTA) parameters at the baseline and treatment requirements over 1-year in eyes with diabetic macular edema (DME).
We followed one eye of each patient with DME without treatment in the preceding 12 months prospectively over one year. Participants underwent 3x3-mm OCTA scans centered on the fovea using Avanti (Optovue) at baseline. DME was defined as eyes with any fluid detected by a custom algorithm in a 3x3-mm area. We measured the foveal avascular zone (FAZ) and extrafoveal (excluding the central 1-mm circle) avascular area (EAA) in the superficial vascular complex (SVC), intermediate capillary plexus (ICP), and deep capillary plexus (DCP). Fluid volume (FV) was assessed in the inner nuclear layer (INL) and outer plexus layer (OPL). Patients received treatment for DME per standard of care. The primary outcome measure was the predictive value of baseline OCTA parameters for treatment requirements for one year.
We included 66 eyes (mean 60 years old, 27 female). The mean number of treatments over 1 year was xx (range 0 to 14), and the mean number of visits was 1.4 ± 2.7 (range 0 to 14). Twenty-three eyes (35%) underwent treatment during the follow-up. These eyes were significantly younger (P = 0.027) and had greater FV in the INL and OPL (P = 0.017 and P = 0.017) at the baseline than eyes without treatment over 1 year. Univariate analyses showed significant associations with the number of treatments for age (rho = -0.28, P = 0.025), FV in the INL (R = 0.35, P = 0.0083), FV in the OPL (R = 0.38, P = 0.0003), and DR severity (R = 0.30, P = 0.016), but not for FAZ, EAA in all layers, and baseline central subfoveal thickness (P > 0.05). In a multivariate linear regression model (R2 = 0.36), FV in the OPL (Standard β = 0.35, P = 0.016) and DR severity (Standard β = 0.36, P = 0.0062) were significant factors.
Greater FV at baseline is a predictor of greater treatment frequency in DME. The vascular metrics at baseline does not predict treatment requirement.
This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.
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