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Evaluation on intraretinal hyperreflective foci density with SD-OCT after Ozurdex application in patients with diabetic macular edema

Session Details

Session Title: Vascular Diseases and Diabetic Retinopathy III

Session Date/Time: Friday 12/09/2014 | 16:30-18:00

Paper Time: 17:42

Venue: Boulevard D

First Author: : M.Kaya TURKEY

Co Author(s): :    S. Kaynak   D. Er   T. Ozturk   N. Kocak     

Abstract Details

Purpose:

To evaluate the change in the density of intraretinal hyperreflective foci in patients with diabetic macular edema (DME) after intravitreal dexamethasone implant (Ozurdex®) application.

Setting:

Twenty-four eyes of 16 patients with DME with persistent fluid on Spectral-domain optic coherence tomography (SD-OCT) despite regular ranibizumab were reviewed. SD-OCT images were obtained baseline, at the first, third and sixth postoperative months.

Methods:

A blind evaluation to detect the exact number of intraretinal hyperreflective foci was performed. The first macular OCT scan was set as a baseline for further retest scans. Gradual change in the density of intraretinal hyperreflective foci was evaluated. Correlation analysis between inflammatory hyperreflective foci and best-corrected visual acuity (BCVA), and macular thickness was also performed.

Results:

The mean age was 54.2±7.9 years. Preoperative mean BCVA (Snellen chart) was 0.26±0.16, whereas it was found as 0.31±0.18, 0.33±0.16, and 0.30±0.16 at the first, third and sixth postoperative months, respectively (p=0.001). Significant improvement in BCVA was achieved in both the first and third postoperative months (p=0.009, p=0.001, respectively). The OCT macular thickness measurement was 567±168, 269±100, 321±154, and 481±167 at baseline, first, third and sixth postoperative months, respectively (p=0.0001). Significant reduction in mean macular thickness was provided in both the first and third postoperative months (p=0.0001, p=0.0001, respectively). Mean number of intraretinal hyperreflective foci was 17.4±9.2, 16.2±12.3, 14.0±12.8, and 18.4±10.4 at baseline, first, third, and sixth postoperative visits (p=0.008). Statistically significant increase was present in the total number of intraretinal hyperreflective deposit in the sixth postoperative month (p=0.004) when compared to baseline, first, and third values. There was no correlation between intraretinal hyperreflective foci and BCVA, and macular thickness in any visit months.

Conclusions:

Although there was significant increase in visual acuity and decrease in macular thickness until the third month, no statistically significant change was demonstrated in intraretinal hyperreflective foci after Ozurdex application in patients with DME. Initial visual acuity, central macular thickness, disruption of cystic septa, disrupted IS/OS layer and presence of subretinal fluid should be taken into account with respect to the new classification of DME in terms of prognosis and predicting visual outcome. Meanwhile hyperreflective foci could not be found as a prognostic feature in our study.

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