Effectiveness of microperimetry in evaluating anti-vascular endothelial growth factor therapy for diabetic macular edema patients with relatively good vision

Abstract

No studies have evaluated the retinal sensitivity (RS) for diabetic macular edema (DME) patients with good vision. Therefore, this study aimed to determine the effectiveness of microperimetry in evaluating the effectiveness of anti-vascular endothelial growth factor (anti-VEGF) treatment for DME patients with relatively good vision. Twenty-seven eyes of 27 patients (mean age, 61.3 ± 11.2 years) with DME and decimal best-corrected visual acuity (BCVA) ≥0.6 were studied. All patients received 3 consecutive monthly injections of intravitreal anti-VEGF agents. The BCVA, central subfield macular thickness (CMT), and RS were evaluated by microperimetry (MAIA) within the 10 degree of the foveal center. To determine significant differences between the values, we used paired t tests. Patients were evaluated at baseline and 4 weeks after the third injection. The BCVA improved significantly from 0.18 ± 0.06 logarithm of the minimum angle of resolution (logMAR) units to 0.13 ± 0.13 logMAR units ( P = .002; paired t test). The CMT decreased significantly from 464.3 ± 91.8 μm to 393.4 ± 129.0 μm ( P = .005), and the RS also improved significantly from 21.8 ± 3.1 dB to 24.1 ± 2.8 dB at 4 weeks after treatment ( P = .006). Among the patients with a decimal BCVA of 0.7 or better at baseline, there was no significant improvement in the BCVA ( P = .28). However, the CMT decreased significantly from 479.5 ± 79.1 μm to 394.0 ± 99.8 μm at 4 weeks after treatment ( P = .007). The RS also improved significantly from 22.0 ± 2.4 dB to 24.0 ± 3.1 dB at 4 weeks after treatment ( P = .004). Measuring RS by microperimetry is a good option for evaluating the effectiveness of anti-VEGF treatment for DME patients with a relatively good BCVA.

Morphological and functional changes in the macular area in diabetic macular edema after a single intravitreal injection of aflibercept

“…On comparing the MLS and the changes in fixation rates at 2° and 4° after and before treatment in patients with DME, the MLS was found to significantly increase after treatment compared with that before treatment, and the results were consistent with the study results of Xu et al [23] . Sugimoto et al [24] treated patients with DME with a monthly intravitreal injection of anti-VEGF agents and found a significant increase in the mean retinal sensitivity of 24.1±2.8 dB after 3mo compared with the baseline of 21.8±3.1 dB (P=0.006), consistent with the results of this study. In our study, P1 did not change significantly from baseline after treatment, and P2 significantly improved from baseline, with statistically significant results (P=0.007), which was not completely consistent with the study results of Seidensticker et al [25] , which might be related to the number of injections and follow-up time.…”

Microperimetry in Retinal Diseases

“…[82][83][84] The retinal sensitivity improvement was significantly correlated with the BCVA and inversely correlated with the OCT central subfield thickness. [85][86][87][88] In addition, Santos and colleagues reported that better retinal sensitivities before treatment were associated with better BCVA outcomes after therapy. This suggested that the baseline MP findings may have prognostic value for DME treatments.…”

“…In addition, following treatment with anti-VEGF agents or intravitreal corticosteroids, improvements in retinal sensitivities have been reported 82–84. The retinal sensitivity improvement was significantly correlated with the BCVA and inversely correlated with the OCT central subfield thickness 85–88. In addition, Santos and colleagues reported that better retinal sensitivities before treatment were associated with better BCVA outcomes after therapy.…”