Patterns of ellipsoid zone change associated with visual outcome for diabetic macular oedema

Tsai, Meng-Ju; Cheng, Cheng-Kuo

doi:10.1080/08164622.2021.1896333

Cited by 3 publications

(4 citation statements)

References 30 publications

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“…Our study showed that age at treatment initiation has a predictive value for the EZ restoration at 1 year, which supports previous reports about increasing age being a negative predictive factor for final VA outcome [40]. These results underline the potential utility of EZ parameters as predictive OCT biomarkers to estimate VA changes after 1 year, which has been described in several retinal diseases associated with macular edema [10,12,18,19,35]. Further studies with prospective design and larger cohorts are needed to evaluate the predictive value of these biomarkers on overall outcomes and potential improvement in disease management in patients with diabetic macular edema.…”

Section: Discussionsupporting

confidence: 89%

“…We investigated the long-term changes of ellipsoid zone integrity during anti-VEGF therapy in DME patients in a real-world setting by evaluating the efficacy of EZ parameters in correlating and predicting VA outcomes at different time points. We followed patients for three years and five years after treatment initiation, in marked contrast to previous analyses which looked at functional and structural outcomes in diabetic patients over an observational period of mostly one year [ 7 , 12 , 30 ]. One earlier study did include clinical data of up to 4 years but did not include OCT parameters.…”

Section: Discussionmentioning

confidence: 99%

“…EZ is defined as the hyperreflective band posterior to the ELM, and its hyperreflectivity is assumed due to high mitochondrial density in the inner segments of photoreceptor cells, indicating the vitality of these photoreceptors [9]. Changes of optical reflectivity of EZ have been observed in retinal pathologies [10][11][12]. Previous studies demonstrated a correlation of recovery of ellipsoid zone and visual acuity in retinal diseases [10,[13][14][15][16][17].…”

Section: Introductionmentioning

confidence: 99%

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Ellipsoid Zone Integrity and Visual Acuity Changes during Diabetic Macular Edema Therapy: A Longitudinal Study

Kessler

Bagautdinov

Khoramnia

2021

Journal of Diabetes Research

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Purpose. Ellipsoid zone (EZ) integrity is identified as a potential biomarker for therapy surveillance and outcome prediction of visual acuity (VA). However, only a few studies report long-term results of over 1 year of clinical and anatomical changes in patients with diabetic macular edema (DME). This study is aimed at describing the long-term VA and anatomical outcomes in spectral domain optical coherence tomography (OCT) (relative ellipsoid zone reflectivity ratio, central macular thickness, and volume) in patients with DME treated with antivascular endothelial growth factor (anti-VEGF) therapy. Furthermore, we studied the correlation between EZ integrity and changes in visual acuity. Methods. 71 eyes of 71 patients were included in this retrospective study. Clinical characteristics were reviewed yearly. OCT data were assessed at baseline and after 1, 3, and 5 years. EZ parameters were quantified automatically. OCT parameters and visual outcome were correlated and analyzed in multivariable regression models. Results. EZ reflectivity ratio correlated with functional outcome in DME patients from baseline to fifth year at all time points (for all p < 0.05 ). EZ reflectivity improved the most in the first year of treatment (0.68 to 0.75; p < 0.05 ) and declined gradually until year 5 of therapy (0.71; compared to baseline p > 0.05 ). Similarly, best VA was achieved after 1 year (0.40 logarithm of the minimum angle of resolution (logMAR) to 0.28 logMAR; p < 0.001 ) and declined gradually until year 5. Final VA in year 5 was comparable to baseline (0.45 logMAR, compared to baseline p > 0.05 ). Together with baseline VA, baseline EZ parameters did predict VA outcome after 1 year ( p < 0.05 ). Concordantly, VA and EZ parameters from year 1 were associated with VA outcome in year 2. Conclusion. This study described the long-term course of EZ changes during anti-VEGF treatment in DME patients. In addition, our results underlined the potential of EZ parameters as novel OCT biomarkers for prediction of VA outcomes during therapy.

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Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Ellipsoid Zone Integrity and Visual Acuity Changes during Diabetic Macular Edema Therapy: A Longitudinal Study

Kessler

Bagautdinov

Khoramnia

2021

Journal of Diabetes Research

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“…Specific endpoints and biomarkers that are clearly linked to visual function and disease progression are needed, particularly for intermediate AMD, where clinical trial enrichment and the evaluation of therapeutic effect are quite challenging. One specific outer retinal feature which has been strongly associated with functional outcomes is ellipsoid zone (EZ) integrity in multiple retinal disorders, including diabetic macular edema (DME), retinal vein occlusion (RVO), postoperative macular hole (MH), and AMD [17][18][19][20][21][22][23][24][25][26]. The EZ, also referred to as the inner segment/outer segment (IS/OS) junction, is observable in SD-OCT as a reflective layer anterior to the retinal pigment epithelium.…”

Section: Introductionmentioning

confidence: 99%

Ellipsoid Zone Integrity and Visual Function in Dry Age-Related Macular Degeneration

Yordi,

Cakir,

Kalra

et al. 2024

JPM

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In this longitudinal retrospective image analysis, conducted on patients diagnosed with dry age-related macular degeneration (AMD) and 5 years of follow-up imaging data, the study aimed to investigate the relationship between ellipsoid zone (EZ) integrity on spectral domain optical coherence tomography (SD-OCT) and visual acuity (VA). Using a machine learning-enabled feature extraction tool, quantitative EZ parameters were derived from SD-OCT images. The analysis revealed significant correlations between EZ integrity metrics and VA. Eyes with excellent VA (≥20/25 Snellen) exhibited higher EZ integrity, including less EZ attenuation, thicker ellipsoid zone-retinal pigment epithelium (EZ-RPE) thickness, and higher EZ intensity, in contrast to eyes with worse VA (≤20/40 Snellen). Additionally, eyes with geographic atrophy (GA) in the foveal region displayed compromised EZ integrity compared to those without GA. Notably, baseline EZ integrity metrics were predictive of future VA loss. These findings suggest that quantitative SD-OCT measurements of EZ integrity could potentially detect early changes in dry AMD and serve as valuable indicators for predicting future functional outcomes. Furthermore, these measurements hold promise for use in clinical trial screenings, offering insights into the progression of the disease and its impact on visual acuity. This study underscores the importance of EZ integrity assessment in understanding and managing dry AMD.

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The Impact of Laboratory Findings and Optical Coherence Tomography Biomarkers on Response to Intravitreal Anti-VEGF Treatment in Patients with Diabetic Macular Edema

Chatziralli

Dimitriou

Lambadiari

et al. 2022

Seminars in Ophthalmology

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Patterns of ellipsoid zone change associated with visual outcome for diabetic macular oedema

Cited by 3 publications

References 30 publications

Ellipsoid Zone Integrity and Visual Acuity Changes during Diabetic Macular Edema Therapy: A Longitudinal Study

Ellipsoid Zone Integrity and Visual Acuity Changes during Diabetic Macular Edema Therapy: A Longitudinal Study

Ellipsoid Zone Integrity and Visual Function in Dry Age-Related Macular Degeneration

The Impact of Laboratory Findings and Optical Coherence Tomography Biomarkers on Response to Intravitreal Anti-VEGF Treatment in Patients with Diabetic Macular Edema

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