Optical Coherence Tomographic morphological changes over the course of Ranibizumab Treatment in Diabetic Macula Edema

Abstract

Background/Objectives The purpose of this study was to present an association among different morphologic subtypes of diabetic macular edema (DME) and their response and changes in morphological features of spectral domain optical coherence tomography (SD-OCT) over time after intravitreal ranibizumab (IVR) injections. Subjects/Methods This retrospective study included 228 eyes of 150 subjects received IVR for DME and were observed for at least 2 years. Medical charts and SD-OCT image of consecutive patients were reviewed at designated time points after first IVR treatment. Results For a total of 228 eyes, 42 eyes (18.4%) were classified as group 1 (with OCT morphological changes) and 186 eyes (81.6%) classified as group 2 (without OCT morphological changes). The baseline best-corrected visual acuity and 2nd year central macula thickness were significantly different between two groups (p=0.035, p=0.001), with group 1 a poor BCVA (log MAR) 0.84±0.39 and greater CMT at 2nd year (354.21±89.02). Vitreomacular interface abnormalities (VIMA) was the most common type of change and developed in 14.9% of patients with DME who received intravitreal injection of ranibizumab treatment during a follow-up period of 24 months. Stroke was found as a risk factor for developing into another DME subtypes with odds ratio 6.381 (p= 0.038). Conclusions Macula edema disappeared rapidly after IVR treatment and might recur or even evolve to other subtypes over time, which may indicate a disease progression with poor outcome. VIMA was the most common type of change and presented in all eyes with DME irrespective of the type of macular edema as classified by SD-OCT.