یازدهمین همایش تحقیقات چشم پزشکی و علوم بینایی ایران

SPECTRAL DOMAIN OPTICAL COHERENCE TOMOGRAPHY BIOMARKERS OF RETINAL HYPERPERMEABILITY AND CHOROIDAL INFLAMMATION AS PREDICTORS OF SHORT-TERM FUNCTIONAL AND ANATOMICAL OUTCOMES IN EYES WITH DIABETIC MACULAR EDEMA TREATED WITH INTRAVITREAL BEVACIZUMAB

Mehdi Mazloumi¹ *, Sanam Samadikhadem² , Morteza Entezari² , Alireza Ramezani² , Homayoun Nikkhah² , J. Fernando Arevalo³

Eye Research Center, Rasoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
Ophthalmic Research Center, Department of Ophthalmology, Imam Hossein Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA

Abstract: To assess spectral-domain optical coherence tomography (SD-OCT) biomarkers of short-term outcomes in eyes with diabetic macular edema (DME) treated with intravitreal Bevacizumab (IVB).

Methods: In a prospective interventional case series, 66 eyes with DME underwent three monthly IVB injections. Best-corrected visual acuity (BCVA) measurement and SD-OCT were performed at baseline and at 3 months (one month after the third injection). Multivariate regression analysis was performed to investigate the baseline SD-OCT parameters as predictors of functional (visual acuity) and anatomical (macular thickness) outcomes.

Results: Patients with diabetic nephropathy had greater sub-foveal choroidal thickness (SFCT) (300.8 ± 35.54 vs. 253.0 ± 50.07 µm, p < 0.01) and were more likely to have subretinal fluid (SRF) (r = 0.26, p = 0.03) at baseline. Multivariate analysis showed that extent of external limiting membrane (ELM) disruption (p = 0.03), and extent of disorganization of retinal inner layers (DRIL) (p = 0.03) at baseline were predictors of BCVA at 3 months, whereas extent of DRIL (p = 0.04) and duration of diabetes mellitus (DM) (p = 0.03) were predictors of central subfield thickness (CST) at 3 months. Presence of epiretinal membrane (ERM) at baseline (p < 0.01) and extent of ELM disruption at baseline (p = 0.01) could predict the change in BCVA and CST over the 3 months course of treatment, respectively.

Conclusion: ELM disruption and DRIL, as the SD-OCT biomarkers of retinal hyperpermeability, can predict shortterm outcomes in DME eyes treated with IVB. Greater SFCT and presence of SRF at baseline, as the SD-OCT biomarkers of choroidal inflammation, are correlated with presence of diabetic nephropathy.