Abstract
We appreciate the comments on our article.1Zur D. Iglicki M. Busch C. et al.OCT biomarkers as functional outcome predictors in diabetic macular edema treated with dexamethasone implant.Ophthalmology. 2018; 125: 267-275Abstract Full Text Full Text PDF PubMed Scopus (128) Google Scholar We only considered 2 conditions for statistical analysis: “attached” statuses (vitreomacular traction, vitreomacular adhesion) and “detached” status (posterior vitreous detachment). The statement in the Discussion regarding an attached vitreoretinal interface as predictive for better visual outcome referred to eyes with vitreomacular traction and adhesion as grouped together versus eyes with a detached vitreoretinal interface. In the baseline OCT measures (Table 2 in the original article), there was only a statistically significant difference between the 2 groups (naive vs refractory) in terms of posterior vitreous detachment, but not when considering vitreomacular entities. Therefore, we only report vitreomacular traction and vitreomacular adhesion as potential predictors to influence treatment outcome.2Sadiq M.A. Soliman M.K. Sarwar S. et al.Effect of vitreomacular adhesion on treatment outcomes in the Ranibizumab for Edema of the Macula in Diabetes (READ-3) Study.Ophthalmology. 2016; 123: 324-329Abstract Full Text Full Text PDF PubMed Scopus (38) Google Scholar The vitreoretinal interface (detached vs vitreomacular adhesion vs vitreomacular traction) was assessed by 3 experienced masked assessors on 3 horizontal spectral-domain OCT images (1 passing the fovea, 2 scans, 500 μm superior and inferior to the fovea). The authors agree that different OCT scanning protocols (i.e., radial scans) might provide additional findings in the assessment of vitreomacular interface syndromes. Nevertheless, horizontal raster scans provided the most reliable and comparable data owing to the retrospective nature of the study and the use of different OCT devices. Re: Zur et al.: OCT biomarkers as functional outcome predictors in diabetic macular edema treated with dexamethasone implant (Ophthalmology. 2018;125:267-275)OphthalmologyVol. 125Issue 9PreviewWe read the article by Zur et al1 with great interest. The authors mention that for every increase in a vitreoretinal interface measure (detached, vitreomacular adhesion, vitreomacular traction), the patient was more likely to gain >10 letters in best-corrected acuity at 4 months. However, it is not clearly mentioned in the Methods section how exactly these interface values are measured. Moreover, in contradiction, the authors mention in the Discussion that the presence of subretinal fluid, photoreceptor ellipsoid zone continuity, absent hyperreflective foci, and an “attached” vitreoretinal interface were identified as biomarkers predicting better visual outcome after dexamethasone implants in eyes with diabetic macular edema. Full-Text PDF
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