Early Visual Functional Outcomes and Morphological Responses to Anti-Vascular Growth Factor Therapy in Diabetic Macular Oedema Using Optical Coherence Tomography Angiography

Supriya Dabir,1 Mohan Rajan,1 Liji Parasseril,1 Vaidehi Bhatt,2 Preetam Samant,3 CAB Webers,4 TTJM Berendschot4 1Department of Retina, Rajan Eye Care Pvt Ltd, Chennai, India; 2Rajiv Gandhi Medical College, Thane, India; 3Department of Retina, PD Hinduja Hospital and Medical Research Center, Mumbai,...

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Autores principales:	Dabir S, Rajan M, Parasseril L, Bhatt V, Samant P, Webers C, Berendschot TTJM
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2021
Materias:	diabetic macular oedema superficial capillary plexus vascular density perfusion density foveal avascular zone optical coherence tomography angiography macular ischemia Ophthalmology RE1-994
Acceso en línea:	https://doaj.org/article/a089ed50f09e4a5489183b9ab9d6ad92
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spelling	oai:doaj.org-article:a089ed50f09e4a5489183b9ab9d6ad922021-12-02T14:08:53ZEarly Visual Functional Outcomes and Morphological Responses to Anti-Vascular Growth Factor Therapy in Diabetic Macular Oedema Using Optical Coherence Tomography Angiography1177-5483https://doaj.org/article/a089ed50f09e4a5489183b9ab9d6ad922021-01-01T00:00:00Zhttps://www.dovepress.com/early-visual-functional-outcomes-and-morphological-responses-to-anti-v-peer-reviewed-article-OPTHhttps://doaj.org/toc/1177-5483Supriya Dabir,1 Mohan Rajan,1 Liji Parasseril,1 Vaidehi Bhatt,2 Preetam Samant,3 CAB Webers,4 TTJM Berendschot4 1Department of Retina, Rajan Eye Care Pvt Ltd, Chennai, India; 2Rajiv Gandhi Medical College, Thane, India; 3Department of Retina, PD Hinduja Hospital and Medical Research Center, Mumbai, India; 4University Eye Clinic, Maastricht, the NetherlandsCorrespondence: Supriya DabirRajan Eye Care Hospital Pvt. Ltd, No. 5, Vidyodaya East 2nd Street, T. Nagar, Chennai, Tamil Nadu 600017, IndiaTel +919900974800Email supriad@gmail.comPurpose: Diabetic macular oedema (DME) is a vision-threatening complication of diabetic retinopathy. Spectral domain optical coherence tomography angiography (OCTA) is useful for assessing DME. We performed serial OCTA measurements before and after 3 monthly intravitreal anti-vascular endothelial growth factor (anti-VEGF) injections to understand its relationship with best corrected visual acuity (BCVA), central macular thickness (CMT) and vascular indices.Methods: OCTA assessment consisting of 6 × 6 mm scans centred on fovea and en-face retinal angiograms were obtained. Scans were done at baseline and at 1 month following each of the 3 intravitreal injections of anti-VEGF (ranibizumab, Lucentis®).Results: Our prospective study included 24 eyes of 24 subjects, aged 63.0 ± 5.0 years. There was a mean gain of 0.07 LogMAR (3 letters) and reduction of CMT, vessel density (VD) and perfusion density (PD) by end of 3rd month. CMT was independently associated with improvement in BCVA. There were significant reductions in FAZ area, VD and PD over 3 months from baseline.Conclusion: At three months, intravitreal anti-VEGF therapy is associated with visual function recovery in DME, with reduction in CMT being the most reliable predictor of response. OCTA shows a reduction in VD and PD respectively suggestive of reduced macular perfusion in the short term. Simultaneous reduction in FAZ size can be due to reversal of manual displacement of the retinal capillaries resulting from resolution of intraretinal oedema.Keywords: diabetic macular oedema, superficial capillary plexus, vascular density, perfusion density, foveal avascular zone, optical coherence tomography angiography, macular ischemiaDabir SRajan MParasseril LBhatt VSamant PWebers CBerendschot TTJMDove Medical Pressarticlediabetic macular oedemasuperficial capillary plexusvascular densityperfusion densityfoveal avascular zoneoptical coherence tomography angiographymacular ischemiaOphthalmologyRE1-994ENClinical Ophthalmology, Vol Volume 15, Pp 331-339 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	diabetic macular oedema superficial capillary plexus vascular density perfusion density foveal avascular zone optical coherence tomography angiography macular ischemia Ophthalmology RE1-994
spellingShingle	diabetic macular oedema superficial capillary plexus vascular density perfusion density foveal avascular zone optical coherence tomography angiography macular ischemia Ophthalmology RE1-994 Dabir S Rajan M Parasseril L Bhatt V Samant P Webers C Berendschot TTJM Early Visual Functional Outcomes and Morphological Responses to Anti-Vascular Growth Factor Therapy in Diabetic Macular Oedema Using Optical Coherence Tomography Angiography
description	Supriya Dabir,1 Mohan Rajan,1 Liji Parasseril,1 Vaidehi Bhatt,2 Preetam Samant,3 CAB Webers,4 TTJM Berendschot4 1Department of Retina, Rajan Eye Care Pvt Ltd, Chennai, India; 2Rajiv Gandhi Medical College, Thane, India; 3Department of Retina, PD Hinduja Hospital and Medical Research Center, Mumbai, India; 4University Eye Clinic, Maastricht, the NetherlandsCorrespondence: Supriya DabirRajan Eye Care Hospital Pvt. Ltd, No. 5, Vidyodaya East 2nd Street, T. Nagar, Chennai, Tamil Nadu 600017, IndiaTel +919900974800Email supriad@gmail.comPurpose: Diabetic macular oedema (DME) is a vision-threatening complication of diabetic retinopathy. Spectral domain optical coherence tomography angiography (OCTA) is useful for assessing DME. We performed serial OCTA measurements before and after 3 monthly intravitreal anti-vascular endothelial growth factor (anti-VEGF) injections to understand its relationship with best corrected visual acuity (BCVA), central macular thickness (CMT) and vascular indices.Methods: OCTA assessment consisting of 6 × 6 mm scans centred on fovea and en-face retinal angiograms were obtained. Scans were done at baseline and at 1 month following each of the 3 intravitreal injections of anti-VEGF (ranibizumab, Lucentis®).Results: Our prospective study included 24 eyes of 24 subjects, aged 63.0 ± 5.0 years. There was a mean gain of 0.07 LogMAR (3 letters) and reduction of CMT, vessel density (VD) and perfusion density (PD) by end of 3rd month. CMT was independently associated with improvement in BCVA. There were significant reductions in FAZ area, VD and PD over 3 months from baseline.Conclusion: At three months, intravitreal anti-VEGF therapy is associated with visual function recovery in DME, with reduction in CMT being the most reliable predictor of response. OCTA shows a reduction in VD and PD respectively suggestive of reduced macular perfusion in the short term. Simultaneous reduction in FAZ size can be due to reversal of manual displacement of the retinal capillaries resulting from resolution of intraretinal oedema.Keywords: diabetic macular oedema, superficial capillary plexus, vascular density, perfusion density, foveal avascular zone, optical coherence tomography angiography, macular ischemia
format	article
author	Dabir S Rajan M Parasseril L Bhatt V Samant P Webers C Berendschot TTJM
author_facet	Dabir S Rajan M Parasseril L Bhatt V Samant P Webers C Berendschot TTJM
author_sort	Dabir S
title	Early Visual Functional Outcomes and Morphological Responses to Anti-Vascular Growth Factor Therapy in Diabetic Macular Oedema Using Optical Coherence Tomography Angiography
title_short	Early Visual Functional Outcomes and Morphological Responses to Anti-Vascular Growth Factor Therapy in Diabetic Macular Oedema Using Optical Coherence Tomography Angiography
title_full	Early Visual Functional Outcomes and Morphological Responses to Anti-Vascular Growth Factor Therapy in Diabetic Macular Oedema Using Optical Coherence Tomography Angiography
title_fullStr	Early Visual Functional Outcomes and Morphological Responses to Anti-Vascular Growth Factor Therapy in Diabetic Macular Oedema Using Optical Coherence Tomography Angiography
title_full_unstemmed	Early Visual Functional Outcomes and Morphological Responses to Anti-Vascular Growth Factor Therapy in Diabetic Macular Oedema Using Optical Coherence Tomography Angiography
title_sort	early visual functional outcomes and morphological responses to anti-vascular growth factor therapy in diabetic macular oedema using optical coherence tomography angiography
publisher	Dove Medical Press
publishDate	2021
url	https://doaj.org/article/a089ed50f09e4a5489183b9ab9d6ad92
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Early Visual Functional Outcomes and Morphological Responses to Anti-Vascular Growth Factor Therapy in Diabetic Macular Oedema Using Optical Coherence Tomography Angiography

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