Optical Coherence Tomography Angiography Biomarkers Predict Anatomical Response to Bevacizumab in Diabetic Macular Edema
Ayman G Elnahry,1 Alia M Noureldine,1 Ahmed A Abdel-Kader,1 Osama A Sorour,2 David J Ramsey3 1Department of Ophthalmology, Faculty of Medicine, Cairo University, Cairo, Egypt; 2Department of Ophthalmology, Faculty of Medicine, Tanta University, Tanta, Egypt; 3Division of Ophthalmology, Lahey Hospita...
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| Format: | Article |
| Language: | English |
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Dove Medical Press
2022-02-01
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| Series: | Diabetes, Metabolic Syndrome and Obesity |
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| Online Access: | https://www.dovepress.com/optical-coherence-tomography-angiography-biomarkers-predict-anatomical-peer-reviewed-fulltext-article-DMSO |
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| author | Elnahry AG Noureldine AM Abdel-Kader AA Sorour OA Ramsey DJ |
| author_facet | Elnahry AG Noureldine AM Abdel-Kader AA Sorour OA Ramsey DJ |
| author_sort | Elnahry AG |
| collection | DOAJ |
| description | Ayman G Elnahry,1 Alia M Noureldine,1 Ahmed A Abdel-Kader,1 Osama A Sorour,2 David J Ramsey3 1Department of Ophthalmology, Faculty of Medicine, Cairo University, Cairo, Egypt; 2Department of Ophthalmology, Faculty of Medicine, Tanta University, Tanta, Egypt; 3Division of Ophthalmology, Lahey Hospital & Medical Center, Tufts University School of Medicine, Boston, MA, USACorrespondence: Ayman G ElnahryDepartment of Ophthalmology, Faculty of Medicine, Cairo University, Cairo, 11956, Egypt, Tel +20 1224927604, Fax +20 223682030, Email ayman_elnahri@hotmail.comPurpose: To identify biomarkers that may predict an early anatomical response to the treatment of diabetic macular edema (DME) with intravitreal bevacizumab (IVB) by means of optical coherence tomography angiography (OCTA).Methods: This study is a retrospective study of treatment-naïve patients with DME who underwent 6 × 6 mm OCTA imaging of the macula at baseline and after three monthly IVB injections. Thirty-six eyes of 23 patients were included. Eyes that demonstrated evidence of an early anatomical response, consisting of a > 10% decrease in central macular thickness (CMT) (n = 18), were compared with those eyes that failed to show such an improvement (n = 18).Results: At baseline, early-response eyes had worse starting best-corrected visual acuity (BCVA, LogMAR 0.84 ± 0.41 versus LogMAR 0.51 ± 0.15, p = 0.004) and a larger CMT (490 ± 135 μm versus 356 ± 33 μm, p = 0.001), but smaller foveal avascular zones (FAZ) (0.309 ± 0.098mm versus 0.413 ± 0.095 mm, p = 0.003) compared with eyes that proved refractory to three monthly injections of IVB. The vascular density (VD) in both the foveal superficial and deep capillary plexuses was significantly greater in eyes that showed an early-treatment response compared with eyes that were non-responders (24.86 ± 6.90% versus 19.98 ± 7.13%, p = 0.045 and 32.30 ± 4.88% versus 26.95 ± 7.25%, p = 0.028, respectively). Early-treatment response to IVB was predicted by starting CMT (r2= 0.266, p = 0.001), FAZ size (r2= 0.234, p = 0.003), and VD in the superficial parafovea (r2= 0.217, p = 0.004) and deep fovea (r2= 0.157, p = 0.037).Conclusion: Projection-resolved OCTA may be useful in predicting an early anatomical response of DME to treatment with IVB.Keywords: anti-VEGF agents, bevacizumab, biomarkers, diabetic macular edema, macular ischemia, macular perfusion, optical coherence tomography angiography |
| first_indexed | 2024-03-12T07:27:42Z |
| format | Article |
| id | doaj.art-e727e63773dc41709f011673db45c8cf |
| institution | Directory Open Access Journal |
| issn | 1178-7007 |
| language | English |
| last_indexed | 2024-03-12T07:27:42Z |
| publishDate | 2022-02-01 |
| publisher | Dove Medical Press |
| record_format | Article |
| series | Diabetes, Metabolic Syndrome and Obesity |
| spelling | doaj.art-e727e63773dc41709f011673db45c8cf2023-09-02T22:04:55ZengDove Medical PressDiabetes, Metabolic Syndrome and Obesity1178-70072022-02-01Volume 1539540572782Optical Coherence Tomography Angiography Biomarkers Predict Anatomical Response to Bevacizumab in Diabetic Macular EdemaElnahry AGNoureldine AMAbdel-Kader AASorour OARamsey DJAyman G Elnahry,1 Alia M Noureldine,1 Ahmed A Abdel-Kader,1 Osama A Sorour,2 David J Ramsey3 1Department of Ophthalmology, Faculty of Medicine, Cairo University, Cairo, Egypt; 2Department of Ophthalmology, Faculty of Medicine, Tanta University, Tanta, Egypt; 3Division of Ophthalmology, Lahey Hospital & Medical Center, Tufts University School of Medicine, Boston, MA, USACorrespondence: Ayman G ElnahryDepartment of Ophthalmology, Faculty of Medicine, Cairo University, Cairo, 11956, Egypt, Tel +20 1224927604, Fax +20 223682030, Email ayman_elnahri@hotmail.comPurpose: To identify biomarkers that may predict an early anatomical response to the treatment of diabetic macular edema (DME) with intravitreal bevacizumab (IVB) by means of optical coherence tomography angiography (OCTA).Methods: This study is a retrospective study of treatment-naïve patients with DME who underwent 6 × 6 mm OCTA imaging of the macula at baseline and after three monthly IVB injections. Thirty-six eyes of 23 patients were included. Eyes that demonstrated evidence of an early anatomical response, consisting of a > 10% decrease in central macular thickness (CMT) (n = 18), were compared with those eyes that failed to show such an improvement (n = 18).Results: At baseline, early-response eyes had worse starting best-corrected visual acuity (BCVA, LogMAR 0.84 ± 0.41 versus LogMAR 0.51 ± 0.15, p = 0.004) and a larger CMT (490 ± 135 μm versus 356 ± 33 μm, p = 0.001), but smaller foveal avascular zones (FAZ) (0.309 ± 0.098mm versus 0.413 ± 0.095 mm, p = 0.003) compared with eyes that proved refractory to three monthly injections of IVB. The vascular density (VD) in both the foveal superficial and deep capillary plexuses was significantly greater in eyes that showed an early-treatment response compared with eyes that were non-responders (24.86 ± 6.90% versus 19.98 ± 7.13%, p = 0.045 and 32.30 ± 4.88% versus 26.95 ± 7.25%, p = 0.028, respectively). Early-treatment response to IVB was predicted by starting CMT (r2= 0.266, p = 0.001), FAZ size (r2= 0.234, p = 0.003), and VD in the superficial parafovea (r2= 0.217, p = 0.004) and deep fovea (r2= 0.157, p = 0.037).Conclusion: Projection-resolved OCTA may be useful in predicting an early anatomical response of DME to treatment with IVB.Keywords: anti-VEGF agents, bevacizumab, biomarkers, diabetic macular edema, macular ischemia, macular perfusion, optical coherence tomography angiographyhttps://www.dovepress.com/optical-coherence-tomography-angiography-biomarkers-predict-anatomical-peer-reviewed-fulltext-article-DMSOanti-vegf agentsbevacizumabbiomarkersdiabetic macular edemamacular ischemiamacular perfusionoptical coherence tomography angiography. |
| spellingShingle | Elnahry AG Noureldine AM Abdel-Kader AA Sorour OA Ramsey DJ Optical Coherence Tomography Angiography Biomarkers Predict Anatomical Response to Bevacizumab in Diabetic Macular Edema Diabetes, Metabolic Syndrome and Obesity anti-vegf agents bevacizumab biomarkers diabetic macular edema macular ischemia macular perfusion optical coherence tomography angiography. |
| title | Optical Coherence Tomography Angiography Biomarkers Predict Anatomical Response to Bevacizumab in Diabetic Macular Edema |
| title_full | Optical Coherence Tomography Angiography Biomarkers Predict Anatomical Response to Bevacizumab in Diabetic Macular Edema |
| title_fullStr | Optical Coherence Tomography Angiography Biomarkers Predict Anatomical Response to Bevacizumab in Diabetic Macular Edema |
| title_full_unstemmed | Optical Coherence Tomography Angiography Biomarkers Predict Anatomical Response to Bevacizumab in Diabetic Macular Edema |
| title_short | Optical Coherence Tomography Angiography Biomarkers Predict Anatomical Response to Bevacizumab in Diabetic Macular Edema |
| title_sort | optical coherence tomography angiography biomarkers predict anatomical response to bevacizumab in diabetic macular edema |
| topic | anti-vegf agents bevacizumab biomarkers diabetic macular edema macular ischemia macular perfusion optical coherence tomography angiography. |
| url | https://www.dovepress.com/optical-coherence-tomography-angiography-biomarkers-predict-anatomical-peer-reviewed-fulltext-article-DMSO |
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