Foveal Microstructure Analysis in Eyes with Diabetic Macular Edema Treated with Vitrectomy

Kogo, Jiro; Shiono, Akira; Sasaki, Hiroki; Yomoda, Ryo; Jujo, Tatsuya; Kitaoka, Yasushi; Takagi, Hitoshi

doi:10.1007/s12325-017-0598-4

Cited by 10 publications

(9 citation statements)

References 25 publications

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“…In addition, the length of the photoreceptor outer segment (PROS), where the visual pigment is concentrated and which can be reduced by inflammation and oxidative stress [17,19,21,[29][30][31][32], is also measurable in OCT images, although it has not been assessed in AMD. PROS length can be sensitive to pathological conditions involving photoreceptor cells; reduced PROS length is associated with worse visual outcomes in branch retinal vein occlusion [33], diabetic macular edema [34], central serous chorioretinopathy [35], and idiopathic epiretinal membrane [36].…”

Section: Introductionmentioning

confidence: 99%

Macular Pigment Optical Density and Photoreceptor Outer Segment Length as Predisease Biomarkers for Age-Related Macular Degeneration

Nagai

Minami

Suzuki

et al. 2020

JCM

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To explore predisease biomarkers, which may help screen for the risk of age-related macular degeneration (AMD) at very early stages, macular pigment optical density (MPOD) and photoreceptor outer segment (PROS) length were analyzed. Thirty late AMD fellow eyes, which are at high risk and represent the predisease condition of AMD, were evaluated and compared with 30 age-matched control eyes without retinal diseases; there was no early AMD involvement in the AMD fellow eyes. MPOD was measured using MPS2® (M.E. Technica Co. Ltd., Tokyo, Japan), and PROS length was measured based on optical coherence tomography images. MPOD levels and PROS length in the AMD fellow eyes were significantly lower and shorter, respectively, than in control eyes. MPOD and PROS length were positively correlated in control eyes (R = 0.386; p = 0.035) but not in AMD fellow eyes. Twenty (67%) AMD fellow eyes met the criteria of MPOD < 0.65 and/or PROS length < 35 μm, while only five (17%) control eyes did. After adjusting for age and sex, AMD fellow eyes more frequently satisfied the definition (p < 0.001; 95% confidence interval, 3.50–60.4; odds ratio, 14.6). The combination of MPOD and PROS length may be a useful biomarker for screening predisease AMD patients, although further studies are required in this regard.

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Section: Introductionmentioning

confidence: 99%

Macular Pigment Optical Density and Photoreceptor Outer Segment Length as Predisease Biomarkers for Age-Related Macular Degeneration

Nagai

Minami

Suzuki

et al. 2020

JCM

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“…[ 15 ] Small gauge vitrectomy presents a proven treatment option in the current treatment of refractory DME. [ 16 , 17 ]…”

Section: Introductionmentioning

confidence: 99%

Biomarkers and predictors for functional and anatomic outcomes for small gauge pars plana vitrectomy and peeling of the internal limiting membrane in naïve diabetic macular edema: The VITAL Study

Iglicki

Lavaque²,

Ozimek

et al. 2018

PLoS ONE

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PurposeWe aimed to investigate biomarkers and predictive factors for visual and anatomical outcome in patients with naïve diabetic macular edema (DME) who underwent small gauge pars plana vitrectomy (PPV) with internal limiting membrane (ILM) peeling as a first line treatment.DesignMulticenter, retrospective, interventional study.Participants120 eyes from 120 patients with naïve DME treated with PPV and ILM peeling with a follow up of 24 months.MethodsChange in baseline best corrected visual acuity (BCVA) and central subfoveal thickness (CST) 1, 6, 12 and 24 months after surgery. Predictive value of baseline BCVA, CST, optical coherence tomography (OCT) features (presence of subretinal fluid (SRF) and photoreceptor damage), and time between DME diagnosis and surgery. Additional treatment for DME needed. Intra- and post-operative complications (cataract rate formation, increased intraocular pressure).Main outcome measuresThe correlation between baseline characteristics and BCVA response (mean change from baseline; categorized improvement ≥5 or ≥10; Early Treatment Diabetic Retinopathy Study (ETDRS) letters) 12 and 24 months after surgery.ResultsMean BCVA was 0.66 ± 0.14 logMAR, 0.52 ± 0.21 logMAR, and 0.53 ± 0.21 logMAR (p<0.001) at baseline, 12 and 24 months, respectively. Shorter time from DME diagnosis until PPV (OR: 0.98, 95% CI: 0.97–0.99, p<0.001) was a predictor for good functional treatment response (area under the curve 0.828). For every day PPV is postponed, the patient’s chances to gain ≥5 letters at 24 months decrease by 1.8%.Presence of SRF was identified as an anatomical predictor of a better visual outcome, (OR: 6.29, 95% CI: 1.16–34.08, p = 0.033). Safety profile was acceptable.ConclusionsOur results reveal a significant functional and anatomical improvement of DME 24 months after primary PPV, without the need for additional treatment. Early surgical intervention and presence of SRF predict good visual outcome. These biomarkers should be considered when treatment is chosen.

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“…The results of recent studies indicated that the changes in the microstructures of the foveal area are correlated with the visual acuity in eyes with DME [ 15 – 20 ]. For example, Mori et al suggested that the transverse length of the ellipsoid zone (EZ) of the photoreceptors was significantly correlated with the visual acuity improvement after ranibizumab injections in eyes with DME [ 15 ].…”

Section: Introductionmentioning

confidence: 99%

“…Shiono et al indicate that PROS length was a predictive marker of postoperative visual acuities in patients with idiopathic epiretinal membrane [ 19 ]. Kogo et al suggest that PROS length was a predictor of visual outcome in patients with DME after vitrectomy [ 20 ]. However, a search of PubMed did not extract any publications that examined the correlation between the PROS length and outer retinal thickness with the visual acuity before and after IVA treatments in eyes with DME.…”

Section: Introductionmentioning

confidence: 99%

Efficacy of One-Year Treatment with Aflibercept for Diabetic Macular Edema with Practical Protocol

Kaiho

Oshitari

Tatsumi

et al. 2017

BioMed Research International

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The purpose of this study was to determine the efficacy of one-year treatment of diabetic macular edema (DME) with intravitreal aflibercept (IVA) injections on a practical protocol. The medical records of 51 eyes of 43 patients who were diagnosed with DME and had received IVA treatments were reviewed. The best-corrected visual acuity (BCVA) and the central macular thickness (CMT) were measured at the baseline and at 1, 3, 6, and 12 months after the IVA. The mean number of IVA injections was 3.8 ± 2.4. The mean BCVA was significantly better and the CMT was thinner after the IVA at all follow-up times (P < 0.05). The BCVA was better in eyes with a serous retinal detachment (SRD) than without a SRD (P < 0.01). There was a significant correlation between the photoreceptor outer segment (PROS) length and BCVA at the baseline and at 12 months after the IVA (P < 0.05). A fewer number of IVA injections significantly improved the BCVA and the CMT in eyes with DME after one-year treatment. IVA was more effective in the SRD+ group than in the SRD− group. The PROS length may be a predictive marker for visual outcomes after one-year treatment with IVA for DME (IRB#2272).

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Foveal Microstructure Analysis in Eyes with Diabetic Macular Edema Treated with Vitrectomy

Abstract: Current surgery helps DME patients to maintain VA and foveal structures. The results suggest that PROS length predicts visual outcome in DME patients following vitrectomy with ILM peeling and additional laser photocoagulation.

Cited by 10 publications

References 25 publications

Macular Pigment Optical Density and Photoreceptor Outer Segment Length as Predisease Biomarkers for Age-Related Macular Degeneration

Macular Pigment Optical Density and Photoreceptor Outer Segment Length as Predisease Biomarkers for Age-Related Macular Degeneration

Biomarkers and predictors for functional and anatomic outcomes for small gauge pars plana vitrectomy and peeling of the internal limiting membrane in naïve diabetic macular edema: The VITAL Study

Efficacy of One-Year Treatment with Aflibercept for Diabetic Macular Edema with Practical Protocol

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