&lt;p&gt;Optical Coherence Tomographic Patterns as Predictors of Structural Outcome After Intravitreal Ranibizumab in Diabetic Macula Edema&lt;/p&gt;

Chen, Nan Ni; Chen, Wei Dar; Lai, Chien Hsiung; Kuo, Chien Neng; Chen, Ching Lung; Huang, Jou Chen; Wu, Pei Chen; Wu, Pei Lun; Chen, Chau Yin

doi:10.2147/opth.s264669

Cited by 14 publications

(11 citation statements)

References 36 publications

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“…19 Chen et al found that studied cases with OCT results of HRF, hyperlipidemia, & coronary artery disease had less improvement in CMT at twoyear follow-up after intravitreal ranibizumab injection. 14 In our study, 66.67% in group 1, 73.33% in group 2 had interrupted inner segment/ outer segment (IS/OS) layer. Zur et al suggested that eyes with continuous IS-OS layers had a good response 2 months after intravitreal dexamethasone implant.…”

Section: Octmentioning

confidence: 45%

The Additive Effect of Topical Dorzolamide-Timolol with Intravitreal Ranibizumab Injection in Diabetic Macular Edema

Gadwal¹,

Madbouly²,

Mansour³

2022

Al-Azhar International Medical Journal

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Background: Intravitreal injection of anti-vascular endothelial growth factor agents is the main therapeutic option in treatment of diabetic macular edema (DME). Some eyes with DME persistent despite frequent injections. Adjuvant therapies that further reduce edema may improve visual outcome. Aim of The Work:To assess influence of topical dorzolamide-timolol with intravitreal ranibizumab injection (IVR) on anatomical and functional outcomes in DME. Patients and Methods: This prospective cohort study included thirty patients (30 eyes) having type 2 DM, aged 45-60 years, all eyes have NPDR with DME. They were divided into 2 groups according to treatment protocol: Group 1: 15 patients (15 eyes) received IVR (3 monthly injection of Lucentis® 0.5 mg/0.05 ml) and adjuvant topical dorzolamide-timolol (Xolamol™ eye drops twice daily). Group 2: 15 patients (15 eyes) received IVR only. Results: Mean BCVA changes were significant in both groups, it changed from 0.93 ± 0.23 logMAR at baseline to 0.73 ± 0.27 (P < 0.001) in group 1 & from 0.93 ± 0.3 logMAR to 0.8 ± 0.33 (P = 0.001) in group 2. changes in mean CMT were significant in both groups, it changed from 568.67 ± 145.76 at baseline to 384 ± 110.63 (P ˂ 0.001) in group 1 & from 513.4 ± 114.54 at baseline to 387.87 ± 119.52 (P ˂ 0.001) in group 2, at 4th month. Comparing group 1 and group 2 from baseline to the last visit, mean changes in BCVA was 0.2 vs 0.13, mean changes in CMT was -184.67μm vs -125.53μm but the differences between the 2 groups were not statistically significant. Conclusion: Adjuvant topical dorzolamide -timolol with IVR had additive effects, but not a statistically significant, on IVR in the treatment of DME over a 4-month-course.

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Section: Octmentioning

confidence: 45%

The Additive Effect of Topical Dorzolamide-Timolol with Intravitreal Ranibizumab Injection in Diabetic Macular Edema

Gadwal¹,

Madbouly²,

Mansour³

2022

Al-Azhar International Medical Journal

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“…The CMT outcome at 2 nd year follow-up showed an average of 390.5 ± 75.3 µm in VIMA group, patients with morphological changes, which had considerable discrepancy in our previous work of favorable improvement in reduction of CMT in VMIA group with consistent IVR injections (13). This nding implies that patients with poor response, underlying physical mechanisms of pathogenesis other than VEGF may be involved and receive bene t from the treatment of surgical relief of traction (27).…”

Section: Discussionmentioning

confidence: 59%

“…Both ERM and VMT presented as a highly re ective band or membrane on the retinal surface. All patients were classi ed into four groups based on the OCT ndings, as our previous work have mentioned (13). DRT group included patients with only pure DRT.…”

Section: Outcome Measurementmentioning

confidence: 99%

Optical Coherence Tomographic morphological changes over the course of Ranibizumab Treatment in Diabetic Macula Edema

Chen

Lai

Liao³

et al. 2022

Preprint

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Background/Objectives The purpose of this study was to present an association among different morphologic subtypes of diabetic macular edema (DME) and their response and changes in morphological features of spectral domain optical coherence tomography (SD-OCT) over time after intravitreal ranibizumab (IVR) injections. Subjects/Methods This retrospective study included 228 eyes of 150 subjects received IVR for DME and were observed for at least 2 years. Medical charts and SD-OCT image of consecutive patients were reviewed at designated time points after first IVR treatment. Results For a total of 228 eyes, 42 eyes (18.4%) were classified as group 1 (with OCT morphological changes) and 186 eyes (81.6%) classified as group 2 (without OCT morphological changes). The baseline best-corrected visual acuity and 2nd year central macula thickness were significantly different between two groups (p=0.035, p=0.001), with group 1 a poor BCVA (log MAR) 0.84±0.39 and greater CMT at 2nd year (354.21±89.02). Vitreomacular interface abnormalities (VIMA) was the most common type of change and developed in 14.9% of patients with DME who received intravitreal injection of ranibizumab treatment during a follow-up period of 24 months. Stroke was found as a risk factor for developing into another DME subtypes with odds ratio 6.381 (p= 0.038). Conclusions Macula edema disappeared rapidly after IVR treatment and might recur or even evolve to other subtypes over time, which may indicate a disease progression with poor outcome. VIMA was the most common type of change and presented in all eyes with DME irrespective of the type of macular edema as classified by SD-OCT.

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“…Optical coherence tomography (OCT) and OCT angiography (OCTA) allow non-invasive recognition of imaging features that define a “DME profile”, distinguishing an inflammatory DME pattern characterized by the presence of subretinal fluid (SRF) and a high number of hyper-reflective foci (HRF) [ 4 , 5 ]. Furthermore, numerous imaging (OCT and OCTA) biomarkers have been identified in DME eyes as predictive of treatment response or disease progression, such as the retinal thickening characteristics [ 3 , 6 , 7 ], the presence, position, and internal reflectivity of microaneurysms (MAS) [ 8 , 9 ], the vitreomacular interface abnormalities (VMIAs) [ 6 ], the ellipsoid zone/external limiting membrane (EZ/ELM) integrity/disruption [ 7 ], the presence of nonperfusion areas (NPAs) [ 10 , 11 ], the foveal avascular zone (FAZ) abnormalities in terms of circularity and dimension [ 12 ], the involvement of deep capillary complex (DCP) [ 10 , 13 ], and the suspended scattering particles in motion (SSPiM) [ 14 , 15 ].…”

Section: Introductionmentioning

confidence: 99%

Prognostic Imaging Biomarkers in Diabetic Macular Edema Eyes Treated with Intravitreal Dexamethasone Implant

Costanzo

Giannini

Geronimo

et al. 2023

JCM

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Background: The aim was to evaluate predictive value of baseline optical coherence tomography (OCT) and OCT angiography (OCTA) parameters in diabetic macular edema (DME) treated with dexamethasone implant (DEXi). Methods: OCT and OCTA parameters were collected: central macular thickness (CMT), vitreomacular abnormalities (VMIAs), intraretinal and subretinal fluid (mixed DME pattern), hyper-reflective foci (HRF), microaneurysms (MAs) reflectivity, ellipsoid zone disruption, suspended scattering particles in motion (SSPiM), perfusion density (PD), vessel length density, and foveal avascular zone. Responders’ (RES) and non-responders’ (n-RES) eyes were classified considering morphological (CMT reduction ≥ 10%) and functional (BCVA change ≥ 5 ETDRS letters) changes after DEXi. Binary logistic regression OCT, OCTA, and OCT/OCTA-based models were developed. Results: Thirty-four DME eyes were enrolled (18 treatment-naïve). OCT-based model combining DME mixed pattern + MAs + HRF and OCTA-based model combining SSPiM and PD showed the best performance to correctly classify the morphological RES eyes. In the treatment-naïve eyes, VMIAs were included with a perfect fit for n-RES eyes. Conclusion: The presence of DME mixed pattern, a high number of parafoveal HRF, hyper-reflective MAs, SSPiM in the outer nuclear layers, and high PD represent baseline predictive biomarkers for DEXi treatment responsiveness. The application of these models to treatment-naïve patients allowed a good identification of n-RES eyes.

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<p>Optical Coherence Tomographic Patterns as Predictors of Structural Outcome After Intravitreal Ranibizumab in Diabetic Macula Edema</p>

Cited by 14 publications

References 36 publications

The Additive Effect of Topical Dorzolamide-Timolol with Intravitreal Ranibizumab Injection in Diabetic Macular Edema

The Additive Effect of Topical Dorzolamide-Timolol with Intravitreal Ranibizumab Injection in Diabetic Macular Edema

Optical Coherence Tomographic morphological changes over the course of Ranibizumab Treatment in Diabetic Macula Edema

Prognostic Imaging Biomarkers in Diabetic Macular Edema Eyes Treated with Intravitreal Dexamethasone Implant

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