Factors Associated with Fluctuations in Central Subfield Thickness in Patients with Diabetic Macular Edema Using Diabetic Retinopathy Clinical Research Protocols T and V

Torjani, Ava; Mahmoudzadeh, Raziyeh; Salabati, Mirataollah; Cai, Louis; Hsu, Jason; Ho, Allen C.; Yonekawa, Yoshihiro; Kuriyan, Ajay E.; Starr, Matthew R.

doi:10.1016/j.xops.2022.100226

Cited by 3 publications

(1 citation statement)

References 34 publications

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“…Doctors and researchers have used CST to evaluate the severity of DME and the efficacy of anti-VEGF therapy. However, CST measurement is easily affected by many factors, such as age, sex, axial length, and retinal atrophy [ 18 ]. Moreover, mixed results regarding the relationship between CST and postoperative vision have been reported.…”

Section: Discussionmentioning

confidence: 99%

Artificial Intelligence-Based Quantification of Central Macular Fluid Volume and VA Prediction for Diabetic Macular Edema Using OCT Images

Ye,

Gao,

et al. 2023

Ophthalmol Ther

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Introduction We studied the correlation of central macular fluid volume (CMFV) and central subfield thickness (CST) with best-corrected visual acuity (BCVA) in treatment-naïve eyes with diabetic macular edema (DME) 1 month after anti-vascular endothelial growth factor (VEGF) therapy. Methods This retrospective cohort study investigated eyes that received anti-VEGF therapy. All participants underwent comprehensive examinations and optical coherence tomography (OCT) volume scans at baseline (M0) and 1 month after the first treatment (M1). Two deep learning models were separately developed to automatically measure the CMFV and the CST. Correlations were analyzed between the CMFV and the logMAR BCVA at M0 and logMAR BCVA at M1. The area under the receiver operating characteristic curve (AUROC) of CMFV and CST for predicting eyes with BCVA 20/40 at M1 was analyzed. Results This study included 156 DME eyes from 89 patients. The median CMFV decreased from 0.272 (0.061–0.568) at M0 to 0.096 (0.018–0.307) mm 3 at M1. The CST decreased from 414 (293–575) to 322 (252–430) μm. The logMAR BCVA decreased from 0.523 (0.301–0.817) to 0.398 (0.222–0.699). Multivariate analysis demonstrated that the CMFV was the only significant factor for logMAR BCVA at both M0 ( β = 0.199, p = 0.047) and M1 ( β = 0.279, p = 0.004). The AUROC of CMFV for predicting eyes with BCVA 20/40 at M1 was 0.72, and the AUROC of CST was 0.69. Conclusions Anti-VEGF therapy is an effective treatment for DME. Automated measured CMFV is a more accurate prognostic factor than CST for the initial anti-VEGF treatment outcome of DME. Supplementary Information The online version contains supplementary material available at 10.1007/s40123-023-00746-5.

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Section: Discussionmentioning

confidence: 99%

Artificial Intelligence-Based Quantification of Central Macular Fluid Volume and VA Prediction for Diabetic Macular Edema Using OCT Images

Ye,

Gao,

et al. 2023

Ophthalmol Ther

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From randomised controlled trials to real-world data: Clinical evidence to guide management of diabetic macular oedema

Gabrielle,

Mehta,

Barthelmes

et al. 2023

Progress in Retinal and Eye Research

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Macular Thickness Fluctuations and Visual Acuity Outcomes After Intravitreal Dexamethasone Implant for Diabetic Macular Edema

Torres-Villaros,

Timoumi,

Fajnkuchen

et al. 2024

Retina

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Purpose: To assess macular thickness fluctuations and their association with visual acuity (VA) outcomes in eyes with diabetic macular edema (DME) treated with intravitreal dexamethasone (DEX) implant. Methods: The standard deviation (SD) of all post-baseline central subfield thicknesses (CST) recorded over a 12-month period after the first injection of DEX implant was used to quantify CST fluctuations. Linear regression models were used to identify factors associated with the VA at 12 months (measured with the Early Treatment of Diabetic Retinopathy Study (ETDRS) score), and predictors of CST SD. Results: A retrospective review of 80 eyes of 80 patients treated with DEX implant for DME revealed a CST SD of 75.3 ± 50.3 μm. The CST SD was negatively associated with the VA at 12 months (-7.7 EDTRS letters for each 100-µm increase in CST SD, p=0.01), while changes in CST from baseline did not show any significant association. Eyes were stratified into quartiles based on the CST SD and a difference by -14.2 letters in VA at 12 months was observed between the first and fourth quartiles (p <0.001). Significant predictors of CST SD included the baseline VA (-12.0 μm for each 10-letter increase, p=0.02), and the number of DEX injections received (n=17.1, p=0.03). Conclusion: Greater fluctuations in retinal thickness were found to be associated with poorer visual outcomes in eyes with DME treated with DEX implant. Analyzing the CST SD could be a more predictive indicator of visual prognosis than individual measurements of the CST.

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Factors Associated with Fluctuations in Central Subfield Thickness in Patients with Diabetic Macular Edema Using Diabetic Retinopathy Clinical Research Protocols T and V

Cited by 3 publications

References 34 publications

Artificial Intelligence-Based Quantification of Central Macular Fluid Volume and VA Prediction for Diabetic Macular Edema Using OCT Images

Artificial Intelligence-Based Quantification of Central Macular Fluid Volume and VA Prediction for Diabetic Macular Edema Using OCT Images

From randomised controlled trials to real-world data: Clinical evidence to guide management of diabetic macular oedema

Macular Thickness Fluctuations and Visual Acuity Outcomes After Intravitreal Dexamethasone Implant for Diabetic Macular Edema

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