Abstract
BackgroundFunctional and anatomical evaluation of patients with ischemic diabetic macular edema after monthly injections of Bevacizumab.MethodsFive eyes from five patients with diabetic macular edema associated with macular ischemia in fluorescein angiography (FA), received 6 monthly intravitreal injections of Bevacizumab. All subjects underwent SD-OCT, FA, OCT angiography (OCTA) and microperimetry at baseline and after 6 months follow-up. Primary outcome measures were improvement of best corrected visual acuity (BCVA), microperimetry and assessment of macular perfusion (foveal avascular zone size and capillary loss).ResultsFive patients completed the follow-up. BCVA improved from 20/180 to 20/74 (p = 0.01) and macular sensitivity improved from 11.66 to 16.26 dB (p < 0.007). We also observed that areas of ischemia on OCTA represented areas of lower macular sensitivity on microperimetry. No changes in macular perfusion status were noted.ConclusionsMonthly intravitreal Bevacizumab in patients with ischemic diabetic macular edema improved BCVA and macular sensitivity without compromise of perfusion in the macula. Capillary dropout areas in OCTA correlated with lower retinal sensitivity on microperimetry.
Highlights
Diabetic macular ischemia (DMI) is an important category of diabetic maculopathy
This study aimed to evaluate the functional and anatomical effect of monthly intravitreal bevacizumab injections in patients with diabetic macular edema (DME) associated with DMI using fluorescein angiography (FA), optical coherence tomography (OCT), OCT angiography (OCTA) and microperimetry
Inclusion criteria included: (1) clinically significant macular edema according to Early Treatment Diabetic Retinopathy Study (ETDRS); (2) foveal avascular zone (FAZ) larger than 500 μm in diameter; (3) central macular thickness (CMT) on optical coherence tomography (OCT) greater than 250 μm; and (4) visual acuity ranging from 20/40 to 20/400
Summary
Diabetic macular ischemia (DMI) is an important category of diabetic maculopathy. Along with diabetic macular edema (DME), it is one of the major causes of vision loss in diabetic patients [1]. DMI is characterized by occlusion and loss of the macular capillary network or capillary dropout [2]. Microperimetry is a technique that combines eye fundus imaging with automated perimetry in a single measurement, allowing anatomical and functional correlations [4]. Studies of ischemic areas and macular non-perfusion in diabetes are sparse in the literature. Patients with DMI demonstrate reduced macular sensitivity on microperimetry, the association with macular edema or their response to anti-VEGF treatment has not been explored [5]. Functional and anatomical evaluation of patients with ischemic diabetic macular edema after monthly injections of Bevacizumab
Sign-in/Register to view highlights & summary 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.
