Optical Coherence Tomography May Be Used to Predict Visual Acuity in Patients with Macular Edema

Pelosini, Lucia; Hull, Christopher C.; Boyce, J.F.; McHugh, Dominic; Stanford, Miles; Marshall, John

doi:10.1167/iovs.09-4493

Cited by 179 publications

(120 citation statements)

References 27 publications

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“…When considering the CMT, the mean difference between baseline and 12 months was similar for the two groups (pre-treated group: 205 μm, naïve group: 173 μm). In agreement with other studies, [17][18][19] this finding points to the complex relationship between VA and CMT, implying that simply reducing oedema does not guarantee improvement in visual function. Concurring with DRCRnet study, results from ADMOR imply that patients who had received previous treatments for DMO can still benefit from ranibizumab injections.…”

Section: Discussionsupporting

confidence: 92%

“…Although greater numbers are required for statistical analysis of this heterogeneous group, these findings agree with other studies that have investigated the relationship between OCT-measured CMT and VA in DMO. [17][18][19] Results show a weak to modest correlation, with at times unpredictable reduction of VA with decrease in CMT. 18 Better understanding of the anatomical changes depicted on OCT is required to specifically assess neuronal survival, which can then be better correlated with VA. 19 Looking at the baseline structure as a predictor for outcome, ADMOR found that the mean baseline VA in eyes with a thinner CMT (55.2 ± 13.4) was not significantly different to the baseline VA of eyes with a thicker CMT (53.8 ± 12.7) (unpaired t-test P = 0.07).…”

Section: Discussionmentioning

confidence: 95%

“…[17][18][19] Results show a weak to modest correlation, with at times unpredictable reduction of VA with decrease in CMT. 18 Better understanding of the anatomical changes depicted on OCT is required to specifically assess neuronal survival, which can then be better correlated with VA. 19 Looking at the baseline structure as a predictor for outcome, ADMOR found that the mean baseline VA in eyes with a thinner CMT (55.2 ± 13.4) was not significantly different to the baseline VA of eyes with a thicker CMT (53.8 ± 12.7) (unpaired t-test P = 0.07). The group of eyes with thinner baseline CMT achieved a greater mean improvement in VA at 12 months, than those with thicker baseline CMT, however, the reduction in CMT was less.…”

Section: Discussionmentioning

confidence: 95%

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South Asian diabetic macular oedema treated with ranibizumab (ADMOR)—real-life experience

Ghanchi

Hazel

2015

Eye

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Purpose Diabetic macular oedema (DMO) is a leading cause for visual impairment in the working age population in the UK. Ranibizumab has been shown to be effective in treatment of DMO in studies based on mainly Caucasian populations. This study reports the 12-month outcome in a cohort of South Asian subjects with DMO treated with ranibizumab. Methods DMO in 51 eyes of 41 South Asian patients was treated with ranibizumab 0.5 mg according to the modified DRCRnet protocol I. Visual acuity (VA) and central macular thickness (CMT) were recorded at baseline, 3, 6, and 12 months. Results were compared for eyes with different baseline visual acuities and different baseline macular thicknesses. Results Over the 12-month period, the mean ETDRS VA increased from 55.3 ± 13.4 letters to 63.8 ± 15.2 letters for all eyes. At 12 months, 70.6% eyes gained 5 or more letters acuity and 17.6% eyes gained 15 letters or more. During the same period, the mean CMT decreased from 532 ± 129 to 318 ± 136 μm. Eyes that had received previous laser treatments had a mean letter gain of 9.2 letters, compared with 8.5 for all eyes at 12 months. Conclusions Ranibizumab 0.5 mg is safe and effective at reversing vision loss due to DMO in patients of South Asian origin at 12 months. Ranibizumab treatment appears to be effective in patients with longstanding DMO who received prior laser treatments. Further studies are needed to define the longterm outcome in patients of different ethnicity and DMO.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 95%

Section: Discussionmentioning

confidence: 95%

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South Asian diabetic macular oedema treated with ranibizumab (ADMOR)—real-life experience

Ghanchi

Hazel

2015

Eye

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“…In fact, a recent study showed that the cross-sectional area of retinal tissue between the plexiform layers in CMO on OCT is the best indicator of visual function. 28 This observation may also be explained by the fact that DRT may represent the milder form of oedema characterised by intracytoplasmic swelling of Muller cells, 29 whereas cystoid spaces result from liquefaction necrosis of Muller cells explaining the poor resolution to treatment. 30 The number of SRDs in our case series was very small to assess its predictive value.…”

Section: Discussionmentioning

confidence: 99%

Qualitative and quantitative OCT response of diffuse diabetic macular oedema to macular laser photocoagulation

Vemala

Koshy

Sivaprasad

2011

Eye

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Purpose To assess the quantitative and morphological changes of the macula in response to macular grid laser for diabetic macular oedema (DMO) using optical coherence tomography (OCT). Patients and Methods Cirrus OCT macular cube scans of 30 eyes of 25 patients were retrospectively analysed before and 4 months after macular grid laser for diffuse DMO. The oedema was quantified and response evaluated in the nine early-treatment diabetic retinopathy study (ETDRS) zones of the macula. Post-laser OCT changes were compared with the baseline features, including morphology patterns, changes in both logarithmic transformed (logOCT) and standardised average macular thickness (AMT), total macular volume, number of parafoveal quadrants involved, and the presence of intact 3rd hyper-reflective band (HRB). Results The rate of change of retinal thickness in response to laser was maximum in the central (8.17%) and perifoveal inferior quadrants (0.04%). Diffuse retinal thickening on OCT responded best to treatment. The AMT of 300-350 lm had the worst response (þ 0.94%). Eyes with less than four quadrants of oedema showed good response. Disrupted HRB was associated with poor visual gain (À0.33 ETDRS letters). Conclusion The topographic location of oedema on the retinal map and the morphological patterns of the oedema on OCT are useful predictors of treatment response in diffuse DMO.

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“…Chronic or severe MO may lead to temporary or permanent visual loss depending on the degree of strain or disruption of the microscopic intraretinal neural connections (transmission defects) and the intracellular damage suffered by the visual elements (transduction defects). 1 Steroids inhibit the formation of both prostaglandins and leukotrienes and decrease intracellular and extracellular oedema by suppression of macrophage activity, vasoconstrictive effect, reduction of lymphokine production, 2 and downregulation of production of vascular endothelial growth factor (VEGF). 3 Several randomized clinical trials have reported good short-term efficacy data on intravitreal triamcinolone acetonide both in terms of improving visual acuity and reducing central retinal thickness (CRT) in patients with MO because of various retinal vascular diseases.…”

Section: Introductionmentioning

confidence: 99%

Monthly OCT monitoring of Ozurdex for macular oedema related to retinal vascular diseases: re-treatment strategy (OCTOME Report 1)

Mathew

Pearce

Muniraju

et al. 2014

Eye

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Purpose To evaluate the morphological and functional changes following intravitreal Ozurdex (dexamethasone implant) injections in patients with macular oedema (MO) secondary to retinal vascular diseases. Design This is a single centre, exploratory phase III, prospective, open-label clinical study. Methods Thirty patients with MO secondary to retinal vascular disorders underwent assessments for best corrected visual acuity, contrast sensitivity, microperimetry, chromatic sensitivity, macular thickness, and morphology using spectral domain optical coherence tomography (SD-OCT) and fluorescein angiography at baseline. They were treated with intravitreal Ozurdex at baseline and monitored monthly with visual acuity and SD-OCT assessments up to 36 weeks. Re-treatment was permitted from 16 to 24 weeks according to pre-defined criteria. All visual function tests were repeated at 24 weeks. Results The mean change in central subfield thickness (CST) from baseline was significant at all visits up to 32 weeks. The lowest mean CST was recorded at 8 weeks and the highest mean ETDRS score was achieved at 12 weeks. All visual functions except contrast sensitivity improved significantly by 24 weeks. The study showed that the ideal re-treatment time point based on functional and structural outcomes and known side-effects of Ozurdex treatment is at 20 weeks. Conclusion Ozurdex therapy has a rapid and dramatic effect on the macula for about 8 weeks followed by a sustained modest effect up to week 32. The optimal re-treatment time point is at 20 weeks.

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Optical Coherence Tomography May Be Used to Predict Visual Acuity in Patients with Macular Edema

Cited by 179 publications

References 27 publications

South Asian diabetic macular oedema treated with ranibizumab (ADMOR)—real-life experience

South Asian diabetic macular oedema treated with ranibizumab (ADMOR)—real-life experience

Qualitative and quantitative OCT response of diffuse diabetic macular oedema to macular laser photocoagulation

Monthly OCT monitoring of Ozurdex for macular oedema related to retinal vascular diseases: re-treatment strategy (OCTOME Report 1)

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