Optical coherence tomography findings predictive of response to treatment in diabetic macular edema

Cho, Young Joo; Lee, Dong Hoon; Kim, Min

doi:10.1177/0300060518798503

Cited by 12 publications

(13 citation statements)

References 26 publications

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“…3 At present, fluorescein angiography (FA) and spectral domain optical coherence tomography (SD-OCT) represent the techniques of choice for assessment and follow-up of diabetic maculopathy (DM). 4 In particular, SD-OCT offers both quantitative and qualitative information in a non-invasive and repeatable way, 5,6 and provides the central subfoveal thickness (CST), which has been widely used both in randomized clinical trials (RCTs) and in clinical practice. 7 The state of the ellipsoid zone (EZ) and the external limiting membrane (ELM), the presence of hyperreflective intraretinal foci (HF), 8 the features of the vitreoretinal interface, 9 the presence of subfoveal fluid (SF), 10 the size of intraretinal cysts, 10 and the occurrence of disorganization of the inner retinal layers (DRIL), alone or in different combinations have been used to categorize DME.…”

Section: Introductionmentioning

confidence: 99%

An optical coherence tomography-based grading of diabetic maculopathy proposed by an international expert panel: The European School for Advanced Studies in Ophthalmology classification

Panozzo

Cicinelli

Augustin

et al. 2019

European Journal of Ophthalmology

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Aims: To present an authoritative, universal, easy-to-use morphologic classification of diabetic maculopathy based on spectral domain optical coherence tomography. Methods: The first draft of the project was developed based on previously published classifications and a literature search regarding the spectral domain optical coherence tomography quantitative and qualitative features of diabetic maculopathy. This draft was sent to an international panel of retina experts for a first revision. The panel met at the European School for Advanced Studies in Ophthalmology headquarters in Lugano, Switzerland, and elaborated the final document. Results: Seven tomographic qualitative and quantitative features are taken into account and scored according to a grading protocol termed TCED-HFV, which includes foveal thickness (T), corresponding to either central subfoveal thickness or macular volume, intraretinal cysts (C), the ellipsoid zone (EZ) and/or external limiting membrane (ELM) status (E), presence of disorganization of the inner retinal layers (D), number of hyperreflective foci (H), subfoveal fluid (F), and vitreoretinal relationship (V). Four different stages of the disease, that is, early diabetic maculopathy, advanced diabetic maculopathy, severe diabetic maculopathy, and atrophic maculopathy, are based on the first four variables, namely the T, C, E, and D. The different stages reflect progressive severity of the disease. Conclusion: A novel grading system of diabetic maculopathy is hereby proposed. The classification is aimed at providing a simple, direct, objective tool to classify diabetic maculopathy (irrespective to the treatment status) even for non-retinal experts and can be used for therapeutic and prognostic purposes, as well as for correct evaluation and reproducibility of clinical investigations.

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Section: Introductionmentioning

confidence: 99%

An optical coherence tomography-based grading of diabetic maculopathy proposed by an international expert panel: The European School for Advanced Studies in Ophthalmology classification

Panozzo

Cicinelli

Augustin

et al. 2019

European Journal of Ophthalmology

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“…4,5 Various patterns of DME have been recognized on SD-OCT, including diffuse retinal thickening (DRT), cystoid macular edema (CME), serous retinal detachment (SRD), and vitreomacular interface abnormalities (VMIAs). [6][7][8][9][10][11][12][13] Previous studies have reported that the effect of intravitreal Bevacizumab (IVB) treatment was predictable among different patterns of DME. 7,9,11,12,14 The anatomic outcome and central macula thickness (CMT) evolution also predicted better vision outcomes.…”

Section: Introductionmentioning

confidence: 99%

“…[6][7][8][9][10][11][12][13] Previous studies have reported that the effect of intravitreal Bevacizumab (IVB) treatment was predictable among different patterns of DME. 7,9,11,12,14 The anatomic outcome and central macula thickness (CMT) evolution also predicted better vision outcomes. 15 It is likely that each morphologic subtype of DME may have distinctive aspects that could be responsible for different anatomic responses to treatment with the currently favored anti-VEGF therapy.…”

Section: Introductionmentioning

confidence: 99%

<p>Optical Coherence Tomographic Patterns as Predictors of Structural Outcome After Intravitreal Ranibizumab in Diabetic Macula Edema</p>

Chen¹,

Chen²,

Lai³

et al. 2020

OPTH

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Background/Objectives: The purpose of this study was to present an association between the treatment response of diabetic macular edema (DME) to intravitreal ranibizumab (IVR) injections and different morphology patterns using spectral domain optical coherence tomography (SD-OCT). Subjects/Methods: This retrospective study included 216 eyes of 142 subjects who received IVR for DME and were observed for at least 2 years. Medical charts and SD-OCT images of consecutive patients were reviewed at baseline, 1, 3, 6, 12, and 24 months after first IVR treatment. The OCT patterns were characterized as diffuse retinal thickening (DRT), cystoid macular edema (CME), serous retinal detachment (SRD), and vitreomacular interface abnormalities (VMIAs). All patients were classified into four groups based on the OCT findings. Results: For a total of 216 eyes, 36 eyes were classified into the DRT group, 76 in the CME group, 42 in the SRD group, and 62 in the VMIA group. There were significant central macula thickness (CMT) improvements in all groups at the 1st month and the 2nd year, except for the DRT group at the 2nd year. Patients with OCT findings of hyperreflective dots (HRDs), metabolic parameters of hyperlipidemia, and coronary artery disease (CAD) had significantly less improvements in CMT at 2-year follow-up (P=0.029, 0.007, <0.001, respectively). Conclusion: A trend toward decreased effectiveness after long-term IVR treatment was observed in the DRT group. Consistent IVR treatment could still achieve favorable improvement in the reduction of CMT in 2-year follow-up in the VMIA group. Different OCT patterns in DME may affect the therapeutic role of anti-VEGF agents and predict the structure outcome.

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“…SRF did not seem to be correlated with BCVA, which was also proven in the previous studies [ 18 ]. Although the pathogenesis of SRF remains unclear, compared with eyes without SRF, DME eyes are considered to have greater severity and more active inflammation of the disease with higher VEGF and interleukin-6 levels [ 19 , 20 ]. Intraretinal cystoids are considered to be located primarily in the outer retinal layers in the former stage and involve almost the entire retinal layer, leaving a thin outer layer in the fovea in the later stage [ 5 ].…”

Section: Discussionmentioning

confidence: 99%

Optical Coherence Tomography Parameters Related to Vision Impairment in Patients with Diabetic Macular Edema: A Quantitative Correlation Analysis

Zhang

Chen

et al. 2020

Journal of Ophthalmology

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Purpose. To quantitatively explore the correlation between optical coherence tomography (OCT) parameters and vision impairment in patients with diabetic macular edema (DME). Methods. This study was a retrospective observational case series. One-hundred eyes from 66 patients with DME were retrospectively included. OCT parameters, including central macular thickness (CMT), height of intraretinal cystoid, subretinal fluid and sponge-like retinal swelling, density of hyperreflective foci (HRF), and integrity of the ellipsoidal zone (EZ), were assessed. Correlation analyses and multiple linear regression analysis were performed to quantitatively explore the relationship between best-corrected visual acuity (BCVA) and OCT parameters. Results. Among all OCT parameters, CMT, height of intraretinal cystoid, height of sponge-like retinal swelling, and density of HRF and EZ integrity were significantly correlated with BCVA (r = −0.550, −0.526, −0.411, −0.277, and −0.501, respectively; P<0.01). In multiple linear regression analysis, CMT, density of HRF, and EZ integrity fit a significant linear equation (β = 0.482, 0.184, and 0.447, respectively), with the adjusted R square reaching 0.522 (P<0.001). In eyes without SRF, the height of intraretinal cystoid, density of HRF, and EZ integrity were included in the model and an adjusted R square of 0.605 (P<0.001) was obtained. Conclusion. In DME eyes, OCT parameters, including the density of HRF, the EZ integrity together with CMT, or the height of intraretinal cystoid, could explain 52.2% to 60.5% of the variation in BCVA and were weighted approximately 2 : 1 : 2, respectively.

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Optical coherence tomography findings predictive of response to treatment in diabetic macular edema

Cited by 12 publications

References 26 publications

An optical coherence tomography-based grading of diabetic maculopathy proposed by an international expert panel: The European School for Advanced Studies in Ophthalmology classification

An optical coherence tomography-based grading of diabetic maculopathy proposed by an international expert panel: The European School for Advanced Studies in Ophthalmology classification

<p>Optical Coherence Tomographic Patterns as Predictors of Structural Outcome After Intravitreal Ranibizumab in Diabetic Macula Edema</p>

Optical Coherence Tomography Parameters Related to Vision Impairment in Patients with Diabetic Macular Edema: A Quantitative Correlation Analysis

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