Abstract
Purpose:To assess the utility of pre-defined imaging biomarkers on optical coherence tomography (OCT) and OCT angiography (OCTA) in patients with diabetic macular edema (DME) following anti-vascular endothelial growth factor (anti-VEGF) therapy in determining visual and anatomical outcomes.Methods:In this prospective, non-randomized, and interventional study, 17 patients with treatment-naive DME were included. OCT biomarkers [size/reflectivity of cysts, disorganization of retinal inner layers, integrity of ellipsoid zone or external limiting membrane, subfoveal serous retinal detachment, hyper-reflective foci (HRF)] and OCTA [vascular density (VD), foveal avascular zone (FAZ), and total micro-aneurysms in superficial capillary plexus and deep capillary plexus (DCP)] were analyzed at baseline and after three monthly intravitreal anti-VEGF injections. Response was defined as a decrease of 10% or more in central macular thickness from the baseline after three injections.Results:13/17 (76.47%) patients were categorized as responders to anti-VEGF therapy. Non-responders had significantly greater hyper-reflectivity of cysts (P = 0.015), larger cystic spaces (P = 0.023), and an increased number of HRF (P = 0.04) at baseline. On OCTA, non-responders showed larger FAZ in DCP (1.35 +/- 0.21 versus 1.14 +/- 0.28 mm2) (P = 0.042) and lower VD (61.17 +/- 0.45 versus 62.73 +/- 3.32) in DCP at baseline. At 3 months, the VD increased in responders (63.10 +/- 3.42) compared to a decrease in non-responders (60.82 +/- 1.13) (P = 0.032).Conclusions:Non-responders show a higher number of micro-aneurysms, larger FAZ, and lower VD in the DCP on OCTA and higher cyst hyper-reflectivity and HRF and larger cystic spaces on OCT imaging.
Original language | English |
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Pages (from-to) | S16-S21 |
Number of pages | 6 |
Journal | Indian Journal of Ophthalmology |
Volume | 72 |
Issue number | SUPPL 1 |
DOIs | |
Publication status | Published - 1 Jan 2024 |
Keywords
- Anti-VEGF
- biomarkers
- diabetic retinopathy
- DME
- OCT
- OPTICAL COHERENCE TOMOGRAPHY
- FOVEAL AVASCULAR ZONE
- VESSEL DENSITY
- ANGIOGRAPHY
- ASSOCIATION
- THERAPY
- ACUITY
- EYES