Choroidal Blood Flow After Intravitreal Ranibizumab in Vitrectomized and Non-Vitrectomized Eyes with Diabetic Macular Edema

Bernardete Pessoa,1,&ast;,2 João Heitor Marques,1,&ast; João Leite,1 Nisa Silva,1 Diana José,1 Constança Coelho,3 João Figueira,4– 6 Angelina Meireles,1,2 João Nuno Melo-Beirão1,2 1Departamento de Oftalmologia, Hospital de Santo António, Centro Hospitalar Universitário do Porto, Porto, Portu...

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Autores principales:	Pessoa B, Marques JH, Leite J, Silva N, José D, Coelho C, Figueira J, Meireles A, Melo-Beirão JN
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2021
Materias:	diabetic macular edema ranibizumab vitrectomy choroidal vascular index choriocapillaris flow Ophthalmology RE1-994
Acceso en línea:	https://doaj.org/article/5b1f2479b793461dbf70f83fea44c617
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spelling	oai:doaj.org-article:5b1f2479b793461dbf70f83fea44c6172021-12-02T17:13:24ZChoroidal Blood Flow After Intravitreal Ranibizumab in Vitrectomized and Non-Vitrectomized Eyes with Diabetic Macular Edema1177-5483https://doaj.org/article/5b1f2479b793461dbf70f83fea44c6172021-10-01T00:00:00Zhttps://www.dovepress.com/choroidal-blood-flow-after-intravitreal-ranibizumab-in-vitrectomized-a-peer-reviewed-fulltext-article-OPTHhttps://doaj.org/toc/1177-5483Bernardete Pessoa,1,&ast;,2 João Heitor Marques,1,&ast; João Leite,1 Nisa Silva,1 Diana José,1 Constança Coelho,3 João Figueira,4– 6 Angelina Meireles,1,2 João Nuno Melo-Beirão1,2 1Departamento de Oftalmologia, Hospital de Santo António, Centro Hospitalar Universitário do Porto, Porto, Portugal; 2Instituto de Ciências Biomédicas Abel Salazar (ICBAS), Universidade do Porto, Porto, Portugal; 3Instituto de Saúde Ambiental, Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal; 4Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal; 5Faculty of Medicine, University of Coimbra, Coimbra, Portugal; 6Association for Innovation and Biomedical Research on Light and Image, Coimbra, Portugal&ast;These authors contributed equally to this workCorrespondence: Bernardete Pessoa Email bbtpessoa@gmail.comAim: Diabetic retinopathy staging system and progression predictors are soon to be considered insufficient for ophthalmologic practice. Given the growing evidence of the role of choroidal dysfunction, our purpose was to assess choroidal vascular changes with intravitreal ranibizumab (RBZ) treatment in diabetic macular edema (DME).Methods: This was a prospective longitudinal cohort study. The study included DME eyes, grouped in vitrectomized (group 1) and non-vitrectomized (group 2) eyes, submitted to RBZ in a pro re nata regimen, with 24 weeks of follow-up. Main outcome measures such as central subfield foveal thickness (CFT), choroidal thickness (CT), and choroidal vascular index (CVI) were obtained from structural OCT, and choriocapillaris flow density (CCD) was obtained from OCT angiography and analyzed before and after treatment.Results: Thirty-one patients were included, 10 eyes in group 1 and 24 eyes in group 2. The mean number of injections was 5.18 (range 2– 6). Globally, there was an improvement in BCVA (+4.3 ETDRS letters, p=0.004) and CFT (− 84.6 μm, p< 0.001) with no changes in CT, CVI, or CCD (p> 0.05). When considering only group 2, there was a significant decrease in CT (p=0.033) and a significant increase in CCD (p=0.010) 6 months after treatment, with no differences in CVI (p=0.111). Baseline CVI was correlated with visual acuity at week 24 both globally (r=0.406, p=0.029) and in group 2 (r=0.604, p=0.004).Conclusion: In non-vitrectomized eyes, choriocapillaris blood flow improves with RBZ. Baseline CVI may correlate with visual function after RBZ. ClinicalTrials.gov NCT04387604.Keywords: diabetic macular edema, ranibizumab, vitrectomy, choroidal vascular index, choriocapillaris flowPessoa BMarques JHLeite JSilva NJosé DCoelho CFigueira JMeireles AMelo-Beirão JNDove Medical Pressarticlediabetic macular edemaranibizumabvitrectomychoroidal vascular indexchoriocapillaris flowOphthalmologyRE1-994ENClinical Ophthalmology, Vol Volume 15, Pp 4081-4090 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	diabetic macular edema ranibizumab vitrectomy choroidal vascular index choriocapillaris flow Ophthalmology RE1-994
spellingShingle	diabetic macular edema ranibizumab vitrectomy choroidal vascular index choriocapillaris flow Ophthalmology RE1-994 Pessoa B Marques JH Leite J Silva N José D Coelho C Figueira J Meireles A Melo-Beirão JN Choroidal Blood Flow After Intravitreal Ranibizumab in Vitrectomized and Non-Vitrectomized Eyes with Diabetic Macular Edema
description	Bernardete Pessoa,1,&ast;,2 João Heitor Marques,1,&ast; João Leite,1 Nisa Silva,1 Diana José,1 Constança Coelho,3 João Figueira,4– 6 Angelina Meireles,1,2 João Nuno Melo-Beirão1,2 1Departamento de Oftalmologia, Hospital de Santo António, Centro Hospitalar Universitário do Porto, Porto, Portugal; 2Instituto de Ciências Biomédicas Abel Salazar (ICBAS), Universidade do Porto, Porto, Portugal; 3Instituto de Saúde Ambiental, Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal; 4Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal; 5Faculty of Medicine, University of Coimbra, Coimbra, Portugal; 6Association for Innovation and Biomedical Research on Light and Image, Coimbra, Portugal&ast;These authors contributed equally to this workCorrespondence: Bernardete Pessoa Email bbtpessoa@gmail.comAim: Diabetic retinopathy staging system and progression predictors are soon to be considered insufficient for ophthalmologic practice. Given the growing evidence of the role of choroidal dysfunction, our purpose was to assess choroidal vascular changes with intravitreal ranibizumab (RBZ) treatment in diabetic macular edema (DME).Methods: This was a prospective longitudinal cohort study. The study included DME eyes, grouped in vitrectomized (group 1) and non-vitrectomized (group 2) eyes, submitted to RBZ in a pro re nata regimen, with 24 weeks of follow-up. Main outcome measures such as central subfield foveal thickness (CFT), choroidal thickness (CT), and choroidal vascular index (CVI) were obtained from structural OCT, and choriocapillaris flow density (CCD) was obtained from OCT angiography and analyzed before and after treatment.Results: Thirty-one patients were included, 10 eyes in group 1 and 24 eyes in group 2. The mean number of injections was 5.18 (range 2– 6). Globally, there was an improvement in BCVA (+4.3 ETDRS letters, p=0.004) and CFT (− 84.6 μm, p< 0.001) with no changes in CT, CVI, or CCD (p> 0.05). When considering only group 2, there was a significant decrease in CT (p=0.033) and a significant increase in CCD (p=0.010) 6 months after treatment, with no differences in CVI (p=0.111). Baseline CVI was correlated with visual acuity at week 24 both globally (r=0.406, p=0.029) and in group 2 (r=0.604, p=0.004).Conclusion: In non-vitrectomized eyes, choriocapillaris blood flow improves with RBZ. Baseline CVI may correlate with visual function after RBZ. ClinicalTrials.gov NCT04387604.Keywords: diabetic macular edema, ranibizumab, vitrectomy, choroidal vascular index, choriocapillaris flow
format	article
author	Pessoa B Marques JH Leite J Silva N José D Coelho C Figueira J Meireles A Melo-Beirão JN
author_facet	Pessoa B Marques JH Leite J Silva N José D Coelho C Figueira J Meireles A Melo-Beirão JN
author_sort	Pessoa B
title	Choroidal Blood Flow After Intravitreal Ranibizumab in Vitrectomized and Non-Vitrectomized Eyes with Diabetic Macular Edema
title_short	Choroidal Blood Flow After Intravitreal Ranibizumab in Vitrectomized and Non-Vitrectomized Eyes with Diabetic Macular Edema
title_full	Choroidal Blood Flow After Intravitreal Ranibizumab in Vitrectomized and Non-Vitrectomized Eyes with Diabetic Macular Edema
title_fullStr	Choroidal Blood Flow After Intravitreal Ranibizumab in Vitrectomized and Non-Vitrectomized Eyes with Diabetic Macular Edema
title_full_unstemmed	Choroidal Blood Flow After Intravitreal Ranibizumab in Vitrectomized and Non-Vitrectomized Eyes with Diabetic Macular Edema
title_sort	choroidal blood flow after intravitreal ranibizumab in vitrectomized and non-vitrectomized eyes with diabetic macular edema
publisher	Dove Medical Press
publishDate	2021
url	https://doaj.org/article/5b1f2479b793461dbf70f83fea44c617
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Choroidal Blood Flow After Intravitreal Ranibizumab in Vitrectomized and Non-Vitrectomized Eyes with Diabetic Macular Edema

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