Optical coherence tomography angiography metrics in different stages of diabetic macular edema

Han, Ruyi; Gong, Ruowen; Liu, Wei; Xu, Gezhi

doi:10.1186/s40662-022-00286-2

Cited by 15 publications

(9 citation statements)

References 38 publications

(39 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Many DME-related biomarkers based on SD-OCT imaging, such as CST, choroidal thickness, HRD, HE, SRF, IRC, EZ or ELM rupture, and DRIL, have been proven to be general prognostic biomarkers of anatomical or functional outcomes [ 16 – 20 ]. In the future, the information parameters of macular perfusion provided by OCTA will be further used in the evaluation system [ 21 ]. A large amount of HRD predicts a slight reduction in CST after anti-VEGF therapy.…”

Section: Discussionmentioning

confidence: 99%

Predictive effect of TCED-HFV grading and imaging biomarkers on anti-VEGF therapy in diabetic macular edema

et al. 2023

View full text Add to dashboard Cite

Background To evaluate the predictive effect of TCED-HFV grading and imaging biomarkers on anti-vascular endothelial growth factor (anti-VEGF) treatment in diabetic macular edema (DME). Methods 81 eyes of 81 DME patients who were treated with anti-VEGF were included in this retrospective cohort study. All patients underwent a comprehensive ophthalmic examination at baseline and follow-up, including best-corrected visual acuity (BCVA), fundus photography, and spectral domain–optical coherence tomography (SD-OCT). Baseline imaging biomarkers were qualitatively and quantitatively graded according to the TCED-HFV classification protocol, and DME was divided into early stage, advanced stage, severe stage, and atrophy stage. Results Six months post treatment, central subfield thickness (CST) in 49 eyes (60.5%) had decreased by 10% from baseline, 30 eyes (37.0%) had achieved CST < 300 μm, and 45 eyes (55.6%) had BCVA improved by more than five letters. Multivariate regression analysis revealed that eyes with baseline CST ≥ 390 μm had a higher probability of ≥ 10% reduction in CST from baseline, and eyes with abundant hyperreflective dots (HRD) had a lower probability of 10% reduction in CST (all P < 0.05). Eyes with vitreomacular traction (VMT) or epiretinal membrane (ERM) at baseline were less likely to reach the end point of CST < 300 μm (P < 0.05). BCVA increases of more than five letters were less likely in eyes with baseline BCVA ≥ 69 letters, complete or partial destruction of ellipsoid zone (EZ) at baseline (all P < 0.05). TCED-HFV staging was negatively correlated with BCVA at both baseline and 6 months (Kendall’s tau-b=-0.39 and − 0.55, all P < 0.01). TCED-HFV staging was positively correlated with CST at 6 months (Kendall’s tau-b = 0.19, P = 0.049) and negatively correlated with the reduction of CST (Kendall’s tau-b=-0.32, P < 0.01). Conclusion The TCED-HFV grading protocol facilitates a comprehensive assessment of DME severity, standardizes the grading of multiple imaging biomarkers, and predicts the anatomical and functional outcomes of anti-VEGF treatment.

show abstract

Section: Discussionmentioning

confidence: 99%

Predictive effect of TCED-HFV grading and imaging biomarkers on anti-VEGF therapy in diabetic macular edema

et al. 2023

View full text Add to dashboard Cite

show abstract

“…Differences were also noted regarding the OCTA quantitative parameters in patients with DME of different grades of severity [ 34 ]. It was concluded that patients with severe DME presented lower perfusion in the DVP, compared to early and advanced DME [ 34 ].…”

Section: Quantitative Octa Assessment In Diabetic Macular Edemamentioning

confidence: 99%

Quantitative Parameters Relevant for Diabetic Macular Edema Evaluation by Optical Coherence Tomography Angiography

et al. 2023

View full text Add to dashboard Cite

Diabetic macular edema (DME) is one of the main ocular complications of diabetes mellitus (DM) that can lead to important vision loss in diabetic patients. In clinical practice, there are cases of DME with unsatisfying treatment responses, despite adequate therapeutic management. Diabetic macular ischemia (DMI) is one of the causes suggested to be associated with the persistence of fluid accumulation. Optical coherence tomography angiography (OCTA) is a non-invasive imaging modality, able to give in-depth information about retinal vascularization in a 3-dimensional manner. The OCTA devices currently available can provide various OCTA metrics that quantitatively assess the retinal microvasculature. In this paper, we reviewed the results of multiple studies that investigated the changes in OCTA metrics in the setting of DME and their possible contribution to the diagnosis, therapeutic management, follow-up and prognosis of patients with DME. We analyzed and compared relevant studies that investigated OCTA parameters related to changes in macular perfusion in the setting of DME and we evaluated the correlations between DME and several quantitative parameters, such as vessel density (VD), perfusion density (PD), foveal avascular zone (FAZ)-related parameters, as well as complexity indices of retinal vasculature. The results of our research showed that OCTA metrics, evaluated especially at the level of the deep vascular plexus (DVP), are useful instruments that can contribute to the assessment of patients with DME.

show abstract

“…Son zamanlarda kullanımı giderek artan OKT-anjiyografi (OKTA) de yüzeyel ve derin kapiller pleksusun değerlendirmesini girişimsel olmayan bir şekilde yaparak, ameliyat öncesi maküler iskemiyi belirleyebilir ve cerrahi sonrası maküler iskemiye bağlı kötü görsel prognozu değerlendirmede yardımcı olabilir. [2] Han Rui ve ark, [21] 92 DMÖ'lü gözü kapsayan kesitsel çalışmalarında, OKTA ile değişen evrelerde DMÖ'lü gözlerde vasküler parametreleri incelemişler; DMÖ ciddiyeti, FAZ alanı ve fovea kalınlığı ile kötü GK arasında korelasyon olduğunu saptamışlardır. OKTA ile, DMÖ'nün şiddeti arttıkça derin kapiller pleksusta vasküler yoğunlukta azalma ve FAZ' da düzensizliğin artarak genişlediği gösterilmiştir.…”

Section: Diyabetik Maküla öDeminin Patofizyolojisi Ve Etki Mekanizmasıunclassified

“…OKTA ile, DMÖ'nün şiddeti arttıkça derin kapiller pleksusta vasküler yoğunlukta azalma ve FAZ' da düzensizliğin artarak genişlediği gösterilmiştir. [21] DRCR.net Protokol I'nın alt analizinde, Anti-VEGF tedavisinin etkili olduğu, GK' de belirgin iyileşme olan DMÖ'lü hastaların, daha genç yaşta, daha az şiddetli DR'si olan ve arayüzey problemi olmayan hastalar olduğunu belirtilmiştir. [22] Bu sonuçları temel alarak vitrektominin özellikle yaşlı, daha şiddetli DR'si olan ve yüzey kırışıklığı olan DMÖ'lü hastalarda bir tedavi seçeneği olabileceği bildirilmiştir.…”

Section: Diyabetik Maküla öDeminin Patofizyolojisi Ve Etki Mekanizmasıunclassified

Surgical Treatment for Diabetic Macular Edema

Aboutable¹

2023

Güncel Retina (Current Retina)

View full text Add to dashboard Cite

Diabetic macular edema (DME) is defined as excess fluid accumulation within the retina in the macular area, and when it is centered on the fovea it is the most common cause of decreased visual acuity in patients with diabetic retinopathy. The development of diabetic macular edema is closely related to the duration of diabetes, poor glycemic control, and type 2 diabetes on insulin therapy. The first-line therapy in diabetic macular edema has been the intravitreal injection of anti-vascular endothelial growth factors (VEGF). Other treatment modalities are intravitreal corticosteroid injection and focal laser photocoagulation. However, the efficacy of intravitreal therapy may decrease significantly over time, especially in the presence of vitreomacular traction, tight posterior hyaloid, or epiretinal membrane (ERM). At this stage, pars plana vitrectomy (PPV) is preferred as an alternative treatment method in eyes with chronic DME resistant to intravitreal injections. The vitreous of diabetic patients contains high amounts of VEGF and Angiotensin 2, which cause DME, and cytokines such as interleukin-6 and ICAM-1. In addition, due to the enzymes, it contains, the vitreous causes cross-linking and thickening of the collagen fibers in its structure, causing tight adhesion and traction on the macula. The mechanism of action of pars plana vitrectomy in macular edema can be explained by removing the vitreous and vitreomacular tractions. Vitrectomy may also increase retinal oxygenation. Selection of the appropriate case is important. The undisturbed integrity of the outer retinal layers including the external limiting membrane(ELM) and the ellipsoid zone, no preoperative foveal ischemia, and performing surgery early before ELM is damaged, have been found to be related to better postoperative visual acuity gain. Further, prospective, randomized, controlled studies with large series including detailed parameters and long follow-up evaluating the efficacy of surgical treatment in diabetic macular edema are warranted.

show abstract

Optical coherence tomography angiography metrics in different stages of diabetic macular edema

Cited by 15 publications

References 38 publications

Predictive effect of TCED-HFV grading and imaging biomarkers on anti-VEGF therapy in diabetic macular edema

Predictive effect of TCED-HFV grading and imaging biomarkers on anti-VEGF therapy in diabetic macular edema

Quantitative Parameters Relevant for Diabetic Macular Edema Evaluation by Optical Coherence Tomography Angiography

Surgical Treatment for Diabetic Macular Edema

Contact Info

Product

Resources

About