Association of retinal vessel calibre and visual outcome in eyes with diabetic macular oedema treated with ranibizumab

Abstract

Purpose The study aims to identify the association between the baseline retinal vascular calibre and visual outcome of patients with diabetic macular oedema (DMO) treated with intravitreal ranibizumab. Methods The 1-M field (as defined in the ETDRS study) of the digital colour fundus photographs of DMO patients who had been treated primarily with ranibizumab in a clinical trial was assessed. Of the 84 patients, 25 had gradable retinal photographs that could be subjected to analyses by the Interactive Vessel Analysis (IVAN) software at baseline. The average retinal vascular calibre of the six largest venules (CRVE) and the six largest arterioles (CRAE) in the peripapillary area (0.5 and 1 disc diameter from the optic disc margin) was measured. The relationship between CRVE and CRAE at baseline and the change in visual acuity at month 12 was assessed using the Mann-Whitney U test. Results Ten eyes from 10 patients who had shown an improvement of Z2 lines of best corrected visual acuity (BCVA) at month 12 had a wider baseline CRVE (248.3±24.5 mm) compared with the 15 eyes from 15 patients who did not show the improvement of Z2 lines (226.6 ± 44.8 mm, Po0.05). The baseline CRAE did not differ significantly in these patients (156.1 ± 22.7 vs 142 ± 17.5 mm, P ¼ 0.17). Conclusions A wider baseline retinal venular calibre may be a predictor of better visual outcome in DMO eyes treated with ranibizumab. Further prospective studies with a larger sample size and a broader range of disease severity and visual acuity are needed to confirm this finding.

Qualitative and Quantitative Assessment of Vascular Changes in Diabetic Macular Edema after Dexamethasone Implant Using Optical Coherence Tomography Angiography

“…Hamanaka et al evaluated retinal ischemia in the peripapillary area in patients with proliferative diabetic retinopathy using fluorescein angiography, and correlated the extension of peripapillary capillary occlusion to angle neovascularization [ 19 ]. Moradi et al showed that wider baseline peripapillary retinal venular caliber may be a predictor of better visual outcome in DME eyes treated with anti-VEGF, probably related to intraocular level of VEGF [ 20 ].…”

Review of the association between retinal microvascular characteristics and eye disease

“…With further investigation, retinal vessel maladaptations may one day feature as biomarkers of treatment response. Wider baseline CRVE has been shown to predict improvement in visual acuity at 12 months in those treated with intra‐vitreal ranibizumab for DMO in a small clinic‐based study, in contrast to the prediction of poor visual outcome in those treated for neovascular AMD . Tatlipinar et al .…”

Der Einfluss von intravitrealem Aflibercept auf das retinale Gefäßkaliber bei Patienten mit diabetischem Makulaödem

“…Nach unserem Kenntnisstand ist dies die erste Studie, die den Einfluss der Anti-VEGF-Behandlung mit Aflibercept auf das retinale Gefäßkaliber bei DR/DMÖ untersucht. Unsere Ergebnisse stehen grundsätzlich im Einklang mit früheren Studien, die ebenfalls retinale vasokonstriktorische Eigenschaften bei Bevacizumab und Ranibizumab nachweisen konnten [11,12,15,16,20]. Im Gegensatz dazu aber scheint Aflibercept zur signifikanten retinalen arteriellen Vasokonstriktion zu führen.…”