Abstract
PurposeTo investigate the relationship between baseline number of hyperreflective foci (HF) on spectral domain optical coherence tomography (SD-OCT) in patients with diabetic macular edema (DME), as well as the dynamics of HF during treatment with anti-vascular endothelial growth factor (VEGF), and treatment response.MethodsWe evaluated patients diagnosed with DME scheduled for treatment with intravitreal bevacizumab. Eyes were classified as adequate or insufficient treatment responders based on logMAR visual acuity improvement and central retinal thickness (CRT) decrease after three consecutive injections. Associations between number of HF at baseline and treatment response, the change in HF over the course of treatment, and the distribution of HF within the retinal layers were evaluated.ResultsIn 54 eyes of 41 patients, mean number of HF and CRT decreased after intravitreal treatment with bevacizumab (p = 0.002 and p<0.001 respectively). Decrease in CRT after 3 months was independently associated with a higher number of HF at baseline (estimated effect -2.61, 95% CI [-4.42–-0.31], p = 0.006). Eyes with adequate treatment response presented with more HF at baseline (OR 1.106, 95% CI [1.012–1.210], p = 0.030) than eyes with insufficient treatment response. Most HF were located within the inner retinal layers, and decrease of HF was mostly due to a decrease of inner retinal HF.ConclusionsIn patients with DME treated with anti-VEGF, higher baseline numbers of HF have predictive value for treatment response in terms of visual acuity improvement and CRT decrease after 3 months. In addition, HF were responsive to anti-VEGF therapy.
Highlights
Diabetic macular edema (DME) is a sight threatening complication of diabetes mellitus (DM) and one of the most frequent causes of vision loss.[1]
In 54 eyes of 41 patients, mean number of hyperreflective foci (HF) and central retinal thickness (CRT) decreased after intravitreal treatment with bevacizumab (p = 0.002 and p
Decrease in CRT after 3 months was independently associated with a higher number of HF at baseline
Summary
Diabetic macular edema (DME) is a sight threatening complication of diabetes mellitus (DM) and one of the most frequent causes of vision loss.[1] Because vascular endothelial growth factor (VEGF) plays a central role in the development of centre-involved DME, anti-VEGF agents have been implemented as the treatment of choice for this condition. Visual function is the most relevant outcome measure, it is a subjective measure of treatment response, and can be influenced by for example fluctuations in glucose levels or the presence of other ocular disorders. Anatomical measurements such as central retinal thickness (CRT) on spectral domain optical coherence tomography (SD-OCT) are a more objective and reliable outcome measure for treatment response. The diabetic retinopathy clinical research network (DRCR.net) employs a combination of both outcome measures and defined insufficient treatment response as a CRT decrease of 10%, or a gain of 5 letters on the Early Treatment of Diabetic Retinopathy Study (ETDRS) chart, the equivalent of 0.1 logMAR.[4, 5]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
