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Choroidal and retinal modifications after anti-VEGF treatment in center involving diabetic macular edema

Session Details

Session Title: Vascular Diseases and Diabetic Retinopathy I

Session Date/Time: Thursday 11/09/2014 | 08:00-10:00

Paper Time: 09:44

Venue: Boulevard C

First Author: : S.Vujosevic ITALY

Co Author(s): :    M. Berton   S. Bini   E. Convento   F. Martini   E. Midena  

Abstract Details

Purpose:

To asses early modifications in foveal choroidal thickness and inner and outer retinal layers structure after anti-VEGF treatment of naive centre-involving diabetic macular edema (DME).

Setting:

Diabetic Retinopathy Clinic, Department of Ophthalmology University of Padova

Methods:

20 eyes (20 diabetic patients), who underwent 3 consecutive intravitreal injections of anti-VEGF (selective and non-selective), underwent a complete ophthalmologic examination: spectral-domain OCT (Retinascan RS-3000, Nidek, Gamagori, Japan), fundus autofluorescence (Heidelberg Spectralis, Heidelberg Engineering, Germany, FAF) and microperimetry (MP1, Gamagori, Japan, MP) at baseline, 1 month after each injection and up to 6 months. Fluorescein angiography (FA) was performed at baseline, at 4 and at 6 month. Foveal choroidal thickness (CT), mean central (CMT) and average (AMT) macular thickness, macular volume (MV), inner and outer retinal thickness, the number of hyperreflective retinal spots (HRS) modifications were avluated by ANOVA test with Dunnet post-hoc. Correlation analyses were performed by Spearman correlation and U test di Mann-Whitney.

Results:

At baseline: CT was 240.8+10.3; CMT was 468.9+52.9; AMT was 367.6+30.6; MV was 13.2+1.1mm3. A significant increase in CT was found after anti-VEGF treatment, p<0.05; whereas a significant decrease was found in CMT, AMT, MV and inner retina (p<0.05 for all measurements) after anti-VEGF treatment. No significant changes in the thickness and structure of the outer retina was found. The number of intraretinal HRS decreased mostly at 1 month in the inner retina. After 3 anti-VEGF injections BCVA and retinal sensitivity (RS) within 4 and 12 degrees significantly increased, (at least p<0.05 for both). A significant correlation was found between decrease of HRS and increase of BCVA and RS (both 4 and 12 degrees).

Conclusions:

The increase in choroidal thickness after multiple anti-VEGF treatments seems to confirm the safety of this treatment. The significant correlation between a decrease of HRS and improvement of BCVA and RS (at 4 and 12 degrees) after 1 injection, suggests that these parameters can be used as early markers for the evaluation of the anti-VEGF treatment. New morphologic and functional parameters should be used for the evaluation of safety and efficacy of anti-VEGF treatments in center involving DME.

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