Optical Coherence Tomographic Patterns in Diabetic Macula Edema Can Predict the Effects of Intravitreal Bevacizumab Injection as Primary Treatment

Wu, Pei‐Chen; Lai, Chia-Yun; Chen, Ching‐Lung; Kuo, Cheng–Deng

doi:10.1089/jop.2011.0070

Cited by 65 publications

(42 citation statements)

References 30 publications

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“…Our observations that number and size of ONL cysts decrease over the course of treatment with intravitreally injected Ranibizumab in patients with DME support the positive effect of anti-VEGF treatment seen in previous works on cystoid macular oedema and may indicate an improved inner blood-retina barrier due to the above mentioned anti-VEGF effect on vascular permeability (Wu et al 2012). Over the course of anti-VEGF treatment, the well-known improvement of the macular function was accompanied by a significant regression of ONL cysts with a significant decrease in their size.…”

Section: Discussionsupporting

confidence: 89%

Functional and morphological changes in diabetic macular edema over the course of anti-vascular endothelial growth factor treatment

et al. 2013

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ABSTRACT.Purpose: To evaluate macular morphology and function in diabetic macular edema (DME) over the course of intravitreal anti-vascular endothelial growth factor (VEGF) treatment with Ranibizumab.Methods: A consecutive series of 39 study eyes with centre-involving DME were included in this study. In all subjects, best-corrected visual acuity (BCVA) according ETDRS protocol, fluorescein angiography (FA), microperimetric macular sensitivity (MP) and Spectral Domain optical coherence tomography (SD-OCT) cross-sectional scans were obtained before treatment and after 3 monthly applied intravitreal Ranibizumab injections. Six different morphological qualities [IS ⁄ OS layer integrity, outer nuclear layer (ONL) cysts, ONL cyst size, inner nuclear layer (INL) cysts, blocking phenomenon and subretinal fluid] were graded of each cross-sectional OCT scan before and over the course of treatment by two experienced graders. Correlation analyses between functional and morphological parameters were obtained. Conclusions: ONL cysts and their size as morphological parameters correlate with retinal function measured with BCVA and microperimetry before and over the course of anti-VEGF therapy with Ranibizumab in patients with DME. Results:

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Section: Discussionsupporting

confidence: 89%

Functional and morphological changes in diabetic macular edema over the course of anti-vascular endothelial growth factor treatment

et al. 2013

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“…However, such patients exhibit a decreased response to anti-VEGF therapy. Previously, VMIAs were found to associate with the use of intravitreal anti-VEGF agents in cases of persistent DME (5,6) . Wu et al suggested that DME with VMIAs may correlate with a poor outcome after anti-VEGF treatment; however, the authors of that study followed patients who received only a single 1.25-mg injection of bevacizumab during a 3-month study period (5) .…”

Section: Discussionmentioning

confidence: 99%

“…Previously, VMIAs were found to associate with the use of intravitreal anti-VEGF agents in cases of persistent DME (5,6) . Wu et al suggested that DME with VMIAs may correlate with a poor outcome after anti-VEGF treatment; however, the authors of that study followed patients who received only a single 1.25-mg injection of bevacizumab during a 3-month study period (5) . Yoon et al studied whether the administration of 3 anti-VEGF injections (either 0.3 mg ranibizumab or 1.25 mg bevacizumab) would affect BCVA and CMT in patients with DME with VMIAs, and observed that significantly reduced improvements in the BCVA of patients with both DME and VMIAs, compared to those with only DME (6) .…”

Section: Discussionmentioning

confidence: 99%

“…Currently, anti-vascular endothelial growth factor (VEGF) agents are considered gold-standard agents in the management of DME and have been shown to improve clinical outcomes (4) . However, the presence or absence of VMIAs could potentially affect responses to anti-VEGF treatment in patients with DME; specifically, these agents may be less effective in patients with VMIAs (5,6) . Vitreomacular traction (VMT) may cause low-grade inflammation and stimulate the induction or progression of DME by inducing the continued release of VEGF, a powerful angiogenic and vascular permeability factor (7,8) .…”

Section: Introductionmentioning

confidence: 99%

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Influence of the epiretinal membrane on ranibizumab therapy outcomes in patients with diabetic macular edema

Erçalık¹,

İmamoğlu²,

Kumral³

et al. 2016

Arquivos Brasileiros De Oftalmologia

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“…In respect to monotherapy with IVB, some authors [25,26] concluded that visual acuity outcomes are better in DRT than in СМЕ and SRD. Others [27,28] found that IVB gives the best results in СМЕ.…”

Section: Discussionmentioning

confidence: 99%

Optical Coherence Tomography Patterns in Diabetic Macular Edema can Predict the Effectiveness of Intravitreal Bevacizumab Combined with Macular Photocoagulation

Radovanova¹

2014

J Clin Exp Ophthalmol

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Purpose: To compare the effectiveness of intravitreal bevacizumab (IVB) combined with macular photocoagulation (MPC) for the treatment of patients with different optical coherence tomography (OCT) patterns of diabetic macular edema. Methods:In this prospective study were included 72 eyes of 58 patients with nonproliferative diabetic retinopathy (NPDR) and nontractional DME with central macular thickness (CMT) over 300 μm. The eyes were categorized into three groups according to OCT features: 22 eyes with diffuse retinal thickening (DRT), 30 eyes with cystoid macular edema (CME), 20 eyes with serous retinal detachment (SRD). All patients received a single dose (1.25mg/0.05ml) of IVB. MPC was applied one month later (25-30 days). Early Treatment Diabetic Retinopahty Study ( ETDRS) best corrected visual acuity (BCVA) and СМТ were assessed before and after the treatment (in the 1st, 3rd and 6th month).Results: At month 6, mean BCVA changed with +8.27 ± 10.7 ETDRS letters (P=0.074), -0.97 ± 8.2 ETDRS letters (P=0.351) and +1.8 ± 10.1 ETDRS letters (P=0.925), respectively, for DRT, CME and SRD groups. Mean CMT decreased by 80.7 ± 65.7 μm (P=0.003) in DRT group, by 24.5 ± 104.6 μm (P=0.909) in CME group and by 51.7 ± 124.3 μm (P=0.580) in SRD group. The DRT group was associated with superior BCVA improvement and greater reduction in CMT as compared with the CME and SRD groups. Conclusions:Intravitreal injection of bevacizumab combined with MPC is more effective in the DRT pattern than in the CME or SRD patterns of DME. The pattern of DME shown by OCT may predict the effectiveness of combination treatment.

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Optical Coherence Tomographic Patterns in Diabetic Macula Edema Can Predict the Effects of Intravitreal Bevacizumab Injection as Primary Treatment

Cited by 65 publications

References 30 publications

Functional and morphological changes in diabetic macular edema over the course of anti-vascular endothelial growth factor treatment

Functional and morphological changes in diabetic macular edema over the course of anti-vascular endothelial growth factor treatment

Influence of the epiretinal membrane on ranibizumab therapy outcomes in patients with diabetic macular edema

Optical Coherence Tomography Patterns in Diabetic Macular Edema can Predict the Effectiveness of Intravitreal Bevacizumab Combined with Macular Photocoagulation

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