Abstract

Purpose: To evaluate factors associated with the presence of foveal bulge (FB) in resolved diabetic macular edema (DME) eyes.Methods: A total of 165 eyes with complete integrity of ellipsoid zone (EZ) at the fovea and resolved DME were divided into two groups according to the presence of FB at 6 months after intravitreal injection of ranibizumab treatment. Best-corrected visual acuity (BCVA), central foveal thickness (CFT), outer nuclear layer (ONL) thickness, height of serous retinal detachment (SRD) and non-SRD, and inner segment (IS) and outer segment (OS) lengths of the two groups were measured and compared at baseline and each follow-up. The correlations between the presence of FB and pre- and post-treatment factors were determined by logistic regression analysis.Results: At baseline, BCVA was significantly better, and CFT and incidence and height of SRD were significantly lower in the FB (+) group (all P < 0.05). At 6 months, FB was present in 65 (39.39%) eyes. Post-treatment BCVA was significantly better and OS length was significantly longer in the FB (+) group at 6 months (all P < 0.05). Multivariate analysis identified younger age, better BCVA, and lower CFT before treatment as significant predictors of the existence of FB at 6 months (all P < 0.05). At 6 months, better BCVA and longer OS length were significantly correlated with the existence of FB (all P < 0.05).Conclusions: Factors associated with the presence of FB after the resolution of DME include younger age, better baseline BCVA and lower baseline CFT, and better post-treatment BCVA and longer post-treatment OS length.

Highlights

  • Diabetic macular edema (DME), affecting 1.4–12.8% of diabetic patients globally, is one of the primary causes of vision impairment in diabetic patients [1,2,3]

  • Since the study is about the retrospective analysis of outcomes of a standard DME treatment and no individual patient could be identified from the data, formal informed consent was waived

  • It appeared that the presence of an intact ellipsoid zone (EZ) at the fovea might not be the only biomarker of satisfactory visual prognosis after the resolution of DME

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Summary

Introduction

Diabetic macular edema (DME), affecting 1.4–12.8% of diabetic patients globally, is one of the primary causes of vision impairment in diabetic patients [1,2,3]. It is important to explore anatomical biomarkers of visual recovery in patients with DME. The visual prognosis is still unsatisfactory in some patients with resolved DME and complete integrity of EZ at the fovea. The same issue occurred in patients with macular edema secondary to branch retinal vein occlusion (BRVO-ME), DME with serous retinal detachment (SRD-DME), and rhegmatogenous retinal detachment [10,11,12]. In these patients, foveal bulge (FB) can serve as a biomarker of better visual recovery after retinal reattachment or complete edema resolution [10,11,12].

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