Session Title: Vascular Diseases I
Session Date/Time: Friday 27/09/2013 | 08:00-10:00
Paper Time: 09:44
Venue: Hall C (Level 1)
First Author: C.Farinha PORTUGAL
Co Author(s): I. Lains J. Figueira A. Santos R. Pinto
To analyze the effect of anti-vascular endothelial growth factor agents (anti-VEGF) in submacular choroidal thickness (CT) of diabetic retinopathy (DR) patients, evaluated by optical coherence tomography (OCT).
Department of Ophthalmology, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal. Associação para a Investigação Biomédica e Inovação em Luz e Imagem, Coimbra, Portugal. Espaço Médico de Coimbra, Coimbra, Portugal. Faculty of Medicine, University of Coimbra, Portugal. Instituto de Retina de Lisboa, Lisboa, Portugal.
Exploratory study, developed in 4 ophthalmology centers where 25 DR patients (50 eyes) were recruited and classified in 2 groups: nonproliferative DR and history of diabetic macular edema (DME) in both eyes (OU), submitted to macular laser OU and anti-VEGF injection only in one eye (NPDR+DME, n=11); proliferative DR OU, treated with panretinal photocoagulation (PRP) OU and anti-VEGF injection only in one eye (PDR, n=14). Images were acquired with spectral-domain OCT Enhanced depth imaging protocol (Heidelberg Engineering-Germany). The line of retinal pigment epithelium/Bruch membrane complex and the line of scleral/choroid interface were marked manually in the 5 central B-scans, by two independent observers blinded to the diagnosis, using MATLAB software (The Mathworks, Natick, MA, USA). The medium CT in central macular area (1mm diameter) (CCT) and the CT in centrofoveal B-scan, measured in 500µm intervals, were obtained automatically.
Considering all the included eyes, those that had been treated with anti-VEGF injections showed a reduction on CCT (248.5±73.7µm versus 285.6±76.9µm, p=0.002) and subfoveal CT (250.7±78.1µm versus 290.8 ±82.3µm, p=0.004), compared with the fellow eyes treated only with laser. Independent evaluation of PDR group revealed similar results (CCT p=0.02; subfoveal CT p=0.02). In NPDR+DME group, CCT was also significantly thinner in anti-VEGF treated eyes (p=0.04). A correlation between the number of injections and a thinner CT was found in this group (p=0.03) and in the evaluation of all eyes together (p=0.03). In PDR group, a positive correlation between the number of PRP spots and CCT (R=0.40; p=0.03) was verified.
To our knowledge, this is the first analysis of the role of anti-VEGF therapy in the CT of DR patients. Eyes treated with anti-VEGF agents, compared with eyes of the same patients treated only with laser, seem to present a reduction in submacular CT evaluated by SD-OCT. PRP may improve submacular CT.