TY - JOUR
T1 - The effect of anti-vascular endothelial growth factor on retinal microvascular changes in diabetic macular edema using swept-source optical coherence tomography angiography
AU - Pongsachareonnont, Pear
AU - Charoenphol, Pulthip
AU - Hurst, Cameron
AU - Somkijrungroj, Thanapong
N1 - Funding Information:
The Ratchadapisek Sompoch Endowment Fund, Faculty of Medicine, Chulalongkorn University , provided grant number; RA 60/004. The funding institute had no part in setting up the study design analysis or in overseeing the results in the manuscript.
Publisher Copyright:
© 2020 Pongsachareonnont et al.
PY - 2020
Y1 - 2020
N2 - Purpose: This study evaluates the effect of anti-vascular endothelial growth factor (anti-VEGF) therapy on microaneurysm changes and foveal avascular zone (FAZ) using optical coherence tomography angiography (OCTA) in patients with diabetic macular edema (DME). Design: Prospective observational study. Materials and Methods: This study involved patients with DME undergoing anti-VEGF treatment (aflibercept, ranibizumab, and bevacizumab). Macula OCTA images were obtained before (visit 0) and 1 month after (visit 1) anti-VEGF injection. Microaneurysm counts were performed, and the FAZ was evaluated in the superficial capillary plexus (SCP) and deep capillary plexus (DCP). The differences in microaneurysms, FAZ, and clinical correlations were analyzed. Results: A total of 152 eyes were analyzed. The patients’ mean age was 59 years. Bevacizumab was used in 69.7%, ranibizumab in 15.1%, and aflibercept in 15.1%. There was a significant reduction in the FAZ in the SCP and DCP between visits 0 and 1. All anti-VEGF medications reduced the number of microaneurysms (p<0.01). After treatment, changes in the FAZ in SCP and DCP corresponded with changes in visual acuity (p<0.01). Conclusion: Microaneurysms as detected by OCTA might serve as a biomarker for a clinical response to anti-VEGF treatment in the short term. The FAZ might also predict visual acuity improvement after anti-VEGF injection.
AB - Purpose: This study evaluates the effect of anti-vascular endothelial growth factor (anti-VEGF) therapy on microaneurysm changes and foveal avascular zone (FAZ) using optical coherence tomography angiography (OCTA) in patients with diabetic macular edema (DME). Design: Prospective observational study. Materials and Methods: This study involved patients with DME undergoing anti-VEGF treatment (aflibercept, ranibizumab, and bevacizumab). Macula OCTA images were obtained before (visit 0) and 1 month after (visit 1) anti-VEGF injection. Microaneurysm counts were performed, and the FAZ was evaluated in the superficial capillary plexus (SCP) and deep capillary plexus (DCP). The differences in microaneurysms, FAZ, and clinical correlations were analyzed. Results: A total of 152 eyes were analyzed. The patients’ mean age was 59 years. Bevacizumab was used in 69.7%, ranibizumab in 15.1%, and aflibercept in 15.1%. There was a significant reduction in the FAZ in the SCP and DCP between visits 0 and 1. All anti-VEGF medications reduced the number of microaneurysms (p<0.01). After treatment, changes in the FAZ in SCP and DCP corresponded with changes in visual acuity (p<0.01). Conclusion: Microaneurysms as detected by OCTA might serve as a biomarker for a clinical response to anti-VEGF treatment in the short term. The FAZ might also predict visual acuity improvement after anti-VEGF injection.
KW - Anti-VEGF
KW - Diabetic macular edema
KW - Diabetic retinopathy
KW - Foveal avascular zone
KW - Microaneurysms
KW - OCT-A
UR - http://www.scopus.com/inward/record.url?scp=85096044287&partnerID=8YFLogxK
U2 - 10.2147/OPTH.S270410
DO - 10.2147/OPTH.S270410
M3 - Article
VL - 14
SP - 3871
EP - 3880
JO - Clinical Ophthalmology
JF - Clinical Ophthalmology
SN - 1177-5483
ER -