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

Abstract

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.

Significance of Hyperreflective Foci as an Optical Coherence Tomography Biomarker in Retinal Diseases: Characterization and Clinical Implications

“…In eyes with DME, HRF located in the outer retinal layers have been strongly associated with worse visual prognosis, disruption of the ELM, photoreceptor loss, and worse prognosis after vitrectomy [6,29,40,41]. An alternative method of studying the integrity of the photoreceptor-RPE complex in the so-called "parallelism" supported that HRF in the outer retinal layers affects photoreceptor layer continuity.…”

A retrospective study assessing the factors associated with visual outcome in retinal vein occlusion patients after anti-VEGF therapy

“…In our study, more than one third of patients experienced hypertension and hyperlipemia, with the univariate analysis and final multivariate analysis, our data demonstrated that hypertension and hyperlipemia impaired the effect of anti-VEGF agents and predicted the poor prognosis of RVO. Additionally, several studies have revealed OCT parameters are related to visual acuity in vascular eye diseases ( Li et al, 2020 ; Sun et al, 2014 ). For example, a relationship between the pre-treatment status of the ELM and post-treatment visual outcome has been described for eye diseases ( Liu et al, 2018 ; Theodossiadis et al, 2011 ).…”

Response of OCT Biomarkers Based on New Diabetic Macular Edema Classification TCED-HFV to Anti-VEGF Therapy and Its Prognostic Role in Vision Benefits

“…Similar progress has been made in patients with DME because OCT has been able to identify various pathologies in these patients, such as CMT, HF, SF, EZ/ELM irregularity and DRIL, and these ndings have begun to clarify the pathogenesis and prognosis of the disease. A large number of studies have been conducted on DME patients receiving anti-VEGF injections, and it has been con rmed that the microstructural changes seen at the baseline by OCT scans can predict the treatment response [14,10,15]. The TCED-HFV classi cation, as a non-invasive diagnostic method, had shown its potential for early diagnosis of DME and could quantitatively response the therapeutic effect to anti-VEGF treatment.…”