Optical Coherence Tomography (Angiography) Biomarkers in the Assessment and Monitoring of Diabetic Macular Edema

Suciu, Corina-Iuliana; Suciu, Vlad-Ioan; Nicoară, Simona Delia

doi:10.1155/2020/6655021

Cited by 43 publications

(30 citation statements)

References 61 publications

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“…Intravitreal injections of anti-VEGF agents or steroid implants have become the main treatment approach for DME patients 17 , 18 . Studies using imaging or aqueous humor biomarkers to identify underlying mechanisms and select effective treatments are currently underway 19 – 21 . Some studies have reported associations between SRF and VEGF or inflammation using aqueous or vitreous sample and associations between SRF and responsiveness to anti-VEGF or steroid implant treatments in DME patients 12 , 14 , 15 , 22 .…”

Section: Discussionmentioning

confidence: 99%

Aqueous humor analyses of diabetic macular edema patients with subretinal fluid

Kwon

Kim

Jee

et al. 2021

Sci Rep

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We identified treatment-naïve diabetic macular edema (DME) patients with or without subretinal fluid (SRF). We compared their baseline characteristics: aqueous concentrations of interleukin (IL)-1β, IL-2, IL-6, IL-8, IL-10, and IL-17, as well as tumor necrosis factor-α, vascular endothelial growth factor (VEGF), and placental growth factor (PlGF). We also compared fundus and optical coherence tomography (OCT) findings, and responsiveness to anti-VEGF treatments. Of 67 DME patients, 18 (26.87%) had SRF. Compared to the no SRF group, the SRF group had significantly higher levels of IL-6, IL-8, VEGF, and PlGF in aqueous humor. After grouping according to diabetic retinopathy stage, non-proliferative diabetic retinopathy (NPDR) patients with SRF had higher aqueous levels of IL-6 and IL-8, compared to NPDR patients without SRF. Moreover, proliferative diabetic retinopathy (PDR) patients with SRF had higher aqueous levels of VEGF and PlGF, compared to PDR patients without SRF. Fundus and OCT analyses revealed that the SRF group had a greater proportion of patients with succinate or patch-shaped hard exudates involving the macula, and greater central subfield thickness (CST) at baseline. After 6 months of anti-VEGF treatments, the SRF group showed better responsiveness in terms of CST; however, visual acuity was not correlated with responsiveness. Considering higher aqueous levels of VEGFs and pro-inflammatory cytokines, SRF could be a biomarker related to diabetic retinopathy activity. DME patients with SRF showed better anatomical responsiveness to anti-VEGF treatments, but did not show better functional improvement on short-term evaluation compared to those of DME patients without SRF.

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Section: Discussionmentioning

confidence: 99%

Aqueous humor analyses of diabetic macular edema patients with subretinal fluid

Kwon

Kim

Jee

et al. 2021

Sci Rep

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“…OCT-A has been an imaging tool of relevance to assess patients with DM, 22 , 28 allowing the characterization of microvascular findings in early stages of DR and preclinical DR, comprising changes in the FAZ area and decreased average and parafoveal VLD and PD compared to controls. 22 – 33 …”

Section: Discussionmentioning

confidence: 99%

“…Macular ischemia : FAZ area enlarging more than 1000 μm in the greatest diameter measured by OCT-A. 27 …”

Section: Methodsmentioning

confidence: 99%

Early microvascular changes in patients with prediabetes evaluated by optical coherence tomography angiography

et al. 2021

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Background: Timely detection of early microvascular changes in patients with prediabetes could help reduce the likelihood of progression of diabetes-related retinal complications. Aim: To determine early microvascular changes in patients with prediabetes using optical coherence tomography angiography (OCT-A). Methods: In this single-center retrospective case-control study, macular OCT-A images of superficial capillary plexus (SCP) and deep capillary plexus (DCP) were analyzed in non-diabetic controls, and prediabetic and diabetic subjects. A quantitative analysis was performed using ImageJ software of the foveal avascular zone (FAZ) area, acircularity index (AI), perfusion density (PD), and vascular length density (VLD). Results: A total of 94 eyes of 53 patients were included in this study. The global mean age was 57.7 years, 39.6% men and 60.4% women. In SCP, the mean PD was 0.283 ± 0.15, 0.186 ± 0.720, and 0.186 ± 0.07 in non-diabetic controls, and prediabetic and diabetic groups, respectively. The mean VLD was 8.728 ± 3.425 in non-diabetic controls, 6.147 ± 1.399 in prediabetic group, and 6.292 ± 1.997 in patients with diabetes. The comparison of prediabetic patients and controls shows statistical differences between PD and VLD in both plexus SCP ( p = 0.002 and p = 0.001, respectively) and DCP ( p = 0.005 and p = 0.002, respectively). The mean area of FAZ in patients with diabetes and normal individuals was 0.281 and 0.196 mm2, respectively ( p < 0.001). AI was higher in the control group (0.87 ± 0.14) and prediabetic group (0.80 ± 0.17) compared to diabetic patients (0.64 ± 0.19). There were no differences in FAZ area and AI between prediabetic and non-diabetic controls. Conclusion: PD and VLD demonstrated to be early microvascular changes in prediabetic patients evaluated by OCT-A. No alterations of FAZ were evidenced in this group.

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“…Furthermore, there are some discrepancies regarding the association between subretinal fluid accumulation and DME duration and severity [ 27 , 44 ]. From the pathogenetic perspective, it is unclear in which proportion the accumulation of subretinal fluid results from its increased entry from the choroid and its insufficient removal by the RPE [ 45 ].…”

Section: Discussionmentioning

confidence: 99%

Quantitative Assessment of Choroidal Parameters in Patients with Various Types of Diabetic Macular Oedema: A Single-Centre Cross-Sectional Analysis

Dmuchowska

Sidorczuk

Pieklarz

et al. 2021

Biology

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Diabetic macular oedema (DME) is an outcome of multiple, complex and not fully understood mechanisms. The aim of this study was to define the role of choroidopathy in the pathogenesis of various DME types. The retrospective cross-sectional single-centre study included 140 eyes from 105 patients with DME and 76 eyes from 52 non-diabetic controls. The eyes were stratified according to the type of DME: cystoid, diffuse, and with subretinal fluid. Optical coherence tomography-based choroidal parameters: thickness, volume, choroidal vascularity index (CVI), luminal area (LA), stromal area (SA), and total choroidal area (TCA) were compared. Eyes with DME, regardless of the type thereof, had lower choroidal thickness, volume, and CVI values than the controls. Further, the eyes with some specific DME types differed significantly from the controls in terms of LA and SA. While the eyes with various DME types did not differ significantly in terms of their choroidal thickness, volume and CVI, some between-group differences were found in LA, SA and TCA. Diabetic choroidopathy seems to play a role in the development of DME but is less likely involved in the pathogenesis of specific types thereof.

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Optical Coherence Tomography (Angiography) Biomarkers in the Assessment and Monitoring of Diabetic Macular Edema

Cited by 43 publications

References 61 publications

Aqueous humor analyses of diabetic macular edema patients with subretinal fluid

Aqueous humor analyses of diabetic macular edema patients with subretinal fluid

Early microvascular changes in patients with prediabetes evaluated by optical coherence tomography angiography

Quantitative Assessment of Choroidal Parameters in Patients with Various Types of Diabetic Macular Oedema: A Single-Centre Cross-Sectional Analysis

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