Effect of a single intravitreal bevacizumab injection on different optical coherence tomographic patterns of diabetic macular oedema

Abstract

Purpose The aim of this study is to compare the therapeutic effect of a single intravitreal bevacizumab (IVB) injection in eyes with diabetic macular oedema (DMO) of different patterns determined by optical coherence tomography (OCT). Methods Medical records of patients who had a single IVB injection for DMO were analysed retrospectively. Eyes with a clinically significant DMO and a central foveal thickness (CFT) of 250 lm or more determined by OCT were included in the analysis. Best-corrected visual acuity (BCVA), CFT and total macular volume values before and after the injection were recorded. Eyes were divided into sponge-like diffuse retinal thickening (DRT), cystoid macular oedema (CMO) and serous retinal detachment (SRD) groups according to the morphology on OCT. Results A total of 92 eyes (42 with DRT, 31 with CMO and 19 with SRD) were included in the study. There was no statistically significant variation between three groups regarding the change in BCVA (P ¼ 0.695). CMO and SRD groups had greater reductions in their mean CFT, and the amount of reduction showed statistically significant variation between three groups (P ¼ 0.048). However, no statistically significant difference was found between groups in terms of percentage of change in CFT (P ¼ 0.278). Conclusion CMO and SRD subtypes are associated with a greater reduction in the CFT than the DRT subtype. Although the change in BCVA was not significantly different between groups, the DRT group showed markedly better visual improvement in proportion to the decrease in CFT.

On the relationship between visual acuity and central retinal (macular) thickness after interventions for macular oedema in diabetics: a review

“…A second level of scrutiny (generally removing case reports, in which the data were not presented in the way defined as suitable et cetera) reduced this further to a total of 140 cohorts reported in 121 different publications, of which only 88 were found to include a full set of data for the planned analyses comparing CMT to VA. The reasons for exclusion were generally because of an incomplete data set (for example, by just reporting percentage changes or the fraction of eyes with a certain range of changes in VA or CMT), leaving 43, nine, 18 and 17 data sets of information for the different interventions (Table ) with some publications yielding more than one set of data …”

“…Specific statements on the use of time‐domain optical coherence tomography method were provided for 76 per cent of the data sets . CMT: central macular thickness.…”

Intravitreal bevacizumab injections for diabetic macular edema – predictors of response: a retrospective study

“…Outcomes seem to be variable among patients, so recent reports have focused on identifying predictors of response. These have looked at systemic8,9 or ocular factors,10 but not in conjunction with each other, which could be important since these factors may be interrelated.…”

Functional outcome of macular edema in different retinal disorders

“…Although CRT and the resolution of intra-retinal cystic spaces is used clinically to evaluate response to treatment, other patterns of macular edema may also predict the response to treatment and restoration of visual function. A variable response is seen in different patterns of macular edema in response to treatment with bevacizumab, with some reports indicating that patients with diffuse macular edema respond better than those with cystoid macular edema or serous retinal detachments , while others suggest they do worse (Koytak et al, 2013;Roh et al, 2010 Q4 ). Other OCT studies reveal that in cases of diabetic macular edema associated with disorganization of the inner retinal layers, visual acuity improvement was related to restoration of the normal retinal layering (Radwan et al, 2015).…”