Changes in Central Choroidal Thickness After Treatment of Diabetic Macular Edema With Intravitreal Bevacizumab Correlation With Central Macular Thickness and Best-Corrected Visual Acuity

Nourinia, Ramin; Ahmadieh, Hamid; Nekoei, Elnaz; Malekifar, Pooneh; Tofighi, Zahra

doi:10.1097/iae.0000000000001645

Cited by 29 publications

(25 citation statements)

References 24 publications

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“…Several studies also have shown that the SFChT decreased after intravitreal injection of anti-vascular endothelial growth factor (VEGF), which suggests that the choroid is sensitive to intraocular VEGF concentration. 19 , 20 The most important finding of the present study was the increase in the SFChT in eyes with treatment-naïve PDR, which had considerably high concentrations of VEGF. 21 , 22 The choroidal thickening in treatment-naïve PDR might reflect the increased concentration of VEGF or a large area of nonperfusion.…”

Section: Discussionmentioning

confidence: 51%

Effects of Systemic Profiles on Choroidal Thickness in Treatment-Naïve Eyes With Diabetic Retinopathy

Choi

Chung

Yoon

et al. 2020

Invest. Ophthalmol. Vis. Sci.

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Purpose The purpose of this study was to analyze the effects of systemic and ocular profiles on subfoveal choroidal thickness (SFChT) in treatment-naïve eyes with diabetic retinopathy (DR). Methods This study included patients with treatment-naïve DR. They underwent routine laboratory evaluations, including complete blood cell count, liver function tests, kidney function tests, and urinalysis for macroalbuminuria. The systemic and ocular factors associated with the change in SFChT in DR were analyzed. Results A total of 136 eyes from 136 patients with diabetes and 30 eyes from 30 age-matched healthy controls were recruited. Generalized linear model analyses showed that the SFChT in treatment-naïve eyes with DR was positively associated with the DR grade and estimated glomerular filtration rate (eGFR; P = 0.001) and negatively associated with age ( P < 0.001) and serum phosphorus levels ( P = 0.001). Treatment-naïve eyes with proliferative DR (PDR; 313.4 ± 9.0 µm) or severe nonproliferative DR (NPDR; 299.7 ± 9.7 µm) had thicker choroid than eyes with mild to moderate NPDR (251.7 ± 11.1 µm) or no DR (231.2 ± 14.5 µm) after adjusting for age, eGFR, and phosphorus levels. Conclusions Choroid is affected by renal function and the grade of DR in patients with diabetes. Advanced retinopathy is associated with choroidal thickening, and the severity of concomitant renal disease is associated with choroidal thinning.

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Section: Discussionmentioning

confidence: 51%

Effects of Systemic Profiles on Choroidal Thickness in Treatment-Naïve Eyes With Diabetic Retinopathy

Choi

Chung

Yoon

et al. 2020

Invest. Ophthalmol. Vis. Sci.

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“…In DME patients, all studies have shown that anti-VEGF injections reduce the central CT, although the clinical consequences of this reduction remain unclear. Some studies have found an association between the decrease in the central CT and the decrease in CRT and the visual gain under anti-VEGF treatment [ 15 ]. Other studies have not been able to find such an association with the visual gain [ 9 , 16 , 17 ].…”

Section: Discussionmentioning

confidence: 99%

“…Campos et al [ 16 ] and Yiu et al [ 17 ] have suggested that the CSCT was not predictive of the anatomical or functional outcomes of DME. However, in a prospective study of 20 eyes of 20 treatment-naive DME patients, a decrease in the central CT 6 months after treatment with 3 IVI of bevacizumab has been shown, and this reduction significantly correlated with a reduction in CRT and with an improvement in visual acuity [ 15 ].…”

Section: Discussionmentioning

confidence: 99%

Comparison of the Effect of Ranibizumab and Aflibercept on Changes in Macular Choroidal Thickness in Patients Treated for Diabetic Macular Edema

Sarda

Eymard

Fajnkuchen

et al. 2020

Journal of Ophthalmology

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Purpose. The aim of this study was to assess the effect of intravitreal injections (IVI) of ranibizumab and aflibercept on the choroidal thickness (CT) in patients with treatment-naive diabetic macular edema (DME) before and after monthly IVI. Patients and Methods. Prospective monocenter study. Inclusion criteria were treatment-naive DME eyes without concomitant panretinal photocoagulation, associated with a decrease in best-corrected visual acuity ≤75 letters on the Early Treatment Diabetic Retinopathy Study (ETDRS) scale. DME was defined by a central retinal thickness ≥300 μm on swept-source OCT (Triton DRI OCT, Topcon Corporation, Itabashi, Japan). Patients received 5 IVI of ranibizumab or aflibercept. The primary endpoint was the change in the central subfield CT (CSCT) between inclusion (M0) and 1 month after the fifth IVI (M5). The secondary endpoint was the CT changes between M0 and M5 in other locations of the macular ETDRS grid. Results. Twenty-four eyes of 24 patients with a mean age of 61.1 years were included. Eleven and 13 patients were, respectively, treated with ranibizumab and aflibercept, and 86.4% had type 2 diabetes. The overall CSCT decreased significantly by −12 μm between M0 and M5 (231.7 μm at M0 and 219.7 μm at M5) (p=0.03). It decreased by −15.2 μm (p=0.02) in the aflibercept group (206.9 μm at M0 and 191.7 μm at M5) and by −7.3 μm (p=0.4) in the ranibizumab group (267.5 μm at M0 and 260.2 μm at M5). The CSCT decreased by −4.9 μm in noninjected contralateral eyes (242.3 μm at M0 and 237.4 μm at M5). CT changes between M0 and M5 in the superior, temporal, inferior, and nasal macular inner ring were significant in the aflibercept group but not in the ranibizumab and control groups. Conclusion. In DME patients, the CSCT decreases after 5 IVI of anti-VEGF, especially after aflibercept treatment.

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“…Other studies have also reported about the effect of PRP on ChT [ 20 ]. Moreover, several studies showed that ChT reduces after intravitreal injection of anti-VEGF [ 21 ]. Thus, we believed that it was essential to exclude eyes with treatment histories.…”

Section: Discussionmentioning

confidence: 99%

Strong Correlation of Renal Function with Choroidal Thickness in Patients with Type 2 Diabetes: Retrospective Cross-Sectional Study

Choi

Kim

2020

JCM

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The purpose of this study was to analyze the correlation between renal function and subfoveal choroidal thickness (SFChT) in treatment-naïve proliferative diabetic retinopathy (PDR) patients. This study included 85 eyes of 52 treatment-naïve PDR patients who underwent kidney function testing and urinalysis and 42 eyes of 33 age-matched controls. Treatment-naïve eyes with PDR were categorized into pachychoroid and leptochoroid groups based on the SFChT of the control group. Kidney function profiles were compared between pachychoroid and leptochoroid groups; the relationship between kidney function profile and SFChT was evaluated using regression analysis. Compared with the pachychoroid group, the leptochoroid group had significantly higher serum creatinine (p = 0.026), cystatin C (p = 0.004), and phosphorus (p < 0.001) levels and a lower estimated glomerular filtration rate (eGFR) (p < 0.001). Multivariate linear regression analyses showed that SFChT was positively correlated with eGFR (Cystatin C) (p = 0.007) and negatively correlated with serum phosphorus (p = 0.001). SFChT of patients with eGFR < 30 mL/min/1.73 m2 and serum phosphorus level ≥4.0 mg/dL was less than that of patients with higher eGFR and lower serum phosphorus level. The choroidal thickness of treatment-naïve PDR patients is closely affected by renal function. Kidney function test should be considered if SFChT of patients with treatment-naïve PDR is reduced.

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Changes in Central Choroidal Thickness After Treatment of Diabetic Macular Edema With Intravitreal Bevacizumab Correlation With Central Macular Thickness and Best-Corrected Visual Acuity

Abstract: After treatment of diabetic macular edema with intravitreal injection of bevacizumab, CCT decreased and this reduction significantly correlated with CMT reduction and vision improvement.

Cited by 29 publications

References 24 publications

Effects of Systemic Profiles on Choroidal Thickness in Treatment-Naïve Eyes With Diabetic Retinopathy

Effects of Systemic Profiles on Choroidal Thickness in Treatment-Naïve Eyes With Diabetic Retinopathy

Comparison of the Effect of Ranibizumab and Aflibercept on Changes in Macular Choroidal Thickness in Patients Treated for Diabetic Macular Edema

Strong Correlation of Renal Function with Choroidal Thickness in Patients with Type 2 Diabetes: Retrospective Cross-Sectional Study

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