Clinical analysis of OCT biomarkers in the treatment of diabetes macular edema
Objective To study the changes of optical coherence tomography(OCT)biomarkers in eyes with diabetic macular edema(DME)treated with anti-vascular endothelial growth factor(VEGF).Methods 56 eyes of 38 patients with central DME were included in this study.They received intravitreal anti-VEGF injection therapy once a month for three consec-utive times from March 2021 to January 2024,and followed by on-demand treatment.During the treatment follow-up period,the following OCT biomarkers were evaluated:subfoveal neuroretinal detachment(SND)[classified as the presence(SND+)or absence(SND-)],hyperreflective walls(HRW)of foveal cystoid spaces[classified as the absence(HRW-)or pres-ence(HRW+)],and disruption of retinal outer layers(DROL)[the integrity of external limiting membrane(ELM)].The changes in SND,HRW,and ELM were assessed at each follow-up visit during follow-up.The interrelationships between base-line of the OCT biomarkers and their changes during follow-up and their correlation with vision outcomes were evaluated.Results The average follow-up duration was 106.3 days.At baseline,SND was detected by OCT in 30.4％of eyes,and HRW was detected by OCT in 82.1％.After the first and third injections,the detection rate of HRW significantly decreased.After the third injection,it was found that the detection rate of SND decreased significantly compared to baseline values.There was no significant correlation between the presence of SND and HRW(P=0.177).There was significant correlation between SND detection and ELM integrity(P＜0.05,r=0.271).The presence or absence of SND,HRW and DROL at baseline showed no significant difference in visual acuity outcomes before and after treatment(all P＞0.05).However,in the eyes with SND(+)at baseline,if SND transformed to SND(-)after treatment,their visual acuity was significantly improved compared to that before treatment(P＜0.05).But if SND persisted,there was no significant improvement in visual acuity compared to that before treatment.When there was no significant improvement in ELM integrity during treatment,there was no significant improvement in visual acuity after treatment(P＞0.05).Conclusion There is no significant correlation between the presence or absence of SND and HRW at baseline and changes in baseline and post-treatment visual acuity.However,the dynamic changes of above biomarkers during follow-up may have a significant impact on visual improvement.The eyes with persistent or recurrent SND and poor ELM integrity during the entire follow-up period would have poor visual improvement.
万方数据
维普
