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Retinal Microvasculature and Visual Acuity after Intravitreal Aflibercept in Diabetic Macular Edema: An Optical Coherence Tomography Angiography Study

Published on Feb 7, 2019in Scientific Reports 4.01
· DOI :10.1038/s41598-018-38248-1
Caleb Busch1
Estimated H-index: 1
(Osaka University),
Taku Wakabayashi16
Estimated H-index: 16
(Osaka University)
+ 7 AuthorsKohji Nishida49
Estimated H-index: 49
(Osaka University)
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Abstract
We investigated changes in retinal vascular area and the foveal avascular zone (FAZ) after intravitreal aflibercept in diabetic macular edema (DME) and the association of these changes with visual outcomes. The retinal vascular area in the superficial capillary plexus (SCP) and the deep capillary plexus (DCP) and the FAZ area were measured using optical coherence tomography angiography (OCTA) in 23 eyes of 23 patients with DME, before and after intravitreal aflibercept. Overall, there was no significant change in retinal vascular area or FAZ. Better BCVA after treatment was significantly associated with larger retinal vascular area in the SCP and the DCP, both at baseline (R2 = 0.512, P < 0.001 and R2 = 0.361, P = 0.002, respectively) and after intravitreal aflibercept (R2 = 0.717, P < 0.001 and R2 = 0.618, P < 0.001, respectively). MAs were observed in the DCP in 20 eyes (87%), but only detected in four eyes (17%) in the SCP before treatment. The number of eyes with MAs in the DCP significantly decreased to 13 (57%) after treatment (P = 0.049). The persistence of DME was associated with persistent MAs (P = 0.019) and less visual gain (P = 0.031) following treatment. Thus, preserving retinal perfusion and the resolution of MAs are associated with better vision and resolution of the DME after intravitreal aflibercept.
  • References (37)
  • Citations (1)
Cite
References37
Newest
Published on Apr 1, 2017in JAMA Ophthalmology 6.17
Mary K. Durbin27
Estimated H-index: 27
(ZEISS: Carl Zeiss AG),
Lin An23
Estimated H-index: 23
(ZEISS: Carl Zeiss AG)
+ 5 AuthorsJosé Cunha-Vaz48
Estimated H-index: 48
Importance Quantitative measurements based on optical coherence tomographic angiography (OCTA) may have value in managing diabetic retinopathy (DR), but there is limited information on the ability of OCTA to distinguish eyes with DR. Objective To evaluate the ability of measurements of retinal microvasculature using OCTA to distinguish healthy eyes from eyes with DR. Design, Setting, and Participants In this prospective cross-sectional study, OCTA was used to examine the eyes of participants wit...
Published on Feb 1, 2017in Ophthalmology 7.73
Wasim A. Samara9
Estimated H-index: 9
(Thomas Jefferson University),
Abtin Shahlaee9
Estimated H-index: 9
(Thomas Jefferson University)
+ 5 AuthorsAllen C. Ho43
Estimated H-index: 43
(Thomas Jefferson University)
Purpose To quantify foveal avascular zone (FAZ) area and macular vascular density objectively using optical coherence tomography angiography (OCTA) and to examine correlations with visual acuity in eyes with diabetic retinopathy (DR) in the absence of diabetic macular edema. Design Retrospective observational case series. Participants Eighty-four eyes from 55 patients with DR and 34 control eyes from 27 age-matched healthy participants. Methods All eyes underwent OCTA (RTVue-XR Avanti; Optovue, ...
Published on Jan 9, 2017in Investigative Ophthalmology & Visual Science 3.81
Khalil Ghasemi Falavarjani16
Estimated H-index: 16
(IUMS: Iran University of Medical Sciences),
Nicholas A. Iafe10
Estimated H-index: 10
(UCLA: University of California, Los Angeles)
+ 3 AuthorsDavid Sarraf33
Estimated H-index: 33
(UCLA: University of California, Los Angeles)
Published on Nov 1, 2016in Ophthalmology 7.73
Junyeop Lee4
Estimated H-index: 4
(Yeungnam University),
Byung Gil Moon7
Estimated H-index: 7
(UOU: University of Ulsan)
+ 1 AuthorsYoung Hee Yoon24
Estimated H-index: 24
(UOU: University of Ulsan)
Purpose To investigate the structural integrity of the superficial capillary plexuses (SCPs) and deep capillary plexuses (DCPs) using optical coherence tomography (OCT) angiography (OCTA) in patients with diabetic macular edema (DME) and its association with the response to anti–vascular endothelial growth factor (VEGF) treatment. Design Retrospective, case-control study. Participants We included 51 DME eyes with a poor response to anti-VEGF agents and 32 age-matched DME eyes with a good respons...
Published on Nov 1, 2016in Ophthalmology 7.73
Chandrakumar Balaratnasingam28
Estimated H-index: 28
,
Maiko Inoue6
Estimated H-index: 6
(Manhattan Eye, Ear and Throat Hospital)
+ 4 AuthorsK. Bailey Freund53
Estimated H-index: 53
(NYU: New York University)
Purpose To determine if the area of the foveal avascular zone (FAZ) is correlated with visual acuity (VA) in diabetic retinopathy (DR) and retinal vein occlusion (RVO). Design Cross-sectional study. Participants Ninety-five eyes of 66 subjects with DR (65 eyes), branch retinal vein occlusion (19 eyes), and central retinal vein occlusion (11 eyes). Methods Structural optical coherence tomography (OCT; Spectralis, Heidelberg Engineering) and OCT angiography (OCTA; Avanti, Optovue RTVue XR) data fr...
Published on Sep 1, 2016in Scientific Reports 4.01
Yuko Miwa6
Estimated H-index: 6
,
Tomoaki Murakami27
Estimated H-index: 27
+ 6 AuthorsNagahisa Yoshimura66
Estimated H-index: 66
Diabetic retinopathy (DR), a diabetic microangiopathy, often leads to severe visual loss in working-age patients1,2. Capillary nonperfusion especially impairs the nutrition of the neuroglial tissues in the retinal parenchyma, and the resultant hypoxia increases expression of vascular endothelial growth factor (VEGF), which promotes both angiogenic responses and vascular permeability3,4, and causes ischemic maculopathy, proliferative diabetic retinopathy (PDR), and diabetic macular edema (DME). F...
Published on Jun 1, 2016in Ophthalmology 7.73
John A. Wells18
Estimated H-index: 18
,
Adam R. Glassman33
Estimated H-index: 33
+ 9 AuthorsChirag D. Jhaveri2
Estimated H-index: 2
Purpose To provide 2-year results comparing anti–vascular endothelial growth factor (VEGF) agents for center-involved diabetic macular edema (DME) using a standardized follow-up and retreatment regimen. Design Randomized clinical trial. Participants Six hundred sixty participants with visual acuity (VA) impairment from DME. Methods Randomization to 2.0-mg aflibercept, 1.25-mg repackaged (compounded) bevacizumab, or 0.3-mg ranibizumab intravitreous injections performed up to monthly using a proto...
Published on Jun 1, 2016in JAMA Ophthalmology 6.17
David A. Salz6
Estimated H-index: 6
(Tufts Medical Center),
Talisa E. de Carlo14
Estimated H-index: 14
(MIT: Massachusetts Institute of Technology)
+ 7 AuthorsNadia K. Waheed29
Estimated H-index: 29
(Tufts Medical Center)
Importance Optical coherence tomographic angiography (OCTA) is a recently developed noninvasive imaging technique that can visualize the retinal and choroidal microvasculature without the injection of exogenous dyes. Objective To evaluate the potential clinical utility of OCTA using a prototype swept-source OCT (SS-OCT) device and compare it with fluorescein angiography (FA) for analysis of the retinal microvasculature in diabetic retinopathy. Design, Setting, and Participants Prospective, obser...
Published on Apr 1, 2016in JAMA Ophthalmology 6.17
Thomas S. Hwang20
Estimated H-index: 20
(OHSU: Oregon Health & Science University),
Simon S. Gao20
Estimated H-index: 20
(OHSU: Oregon Health & Science University)
+ 6 AuthorsYali Jia26
Estimated H-index: 26
(OHSU: Oregon Health & Science University)
Importance Macular ischemia is a key feature of diabetic retinopathy (DR). Quantification of macular ischemia has potential as a biomarker for DR. Objective To assess the feasibility of automated quantification of capillary nonperfusion as a potential sign of macular ischemia using optical coherence tomography (OCT) angiography. Design, Setting, and Participants An observational study conducted in a tertiary, subspecialty, academic practice evaluated macular nonperfusion with 6 × 6-mm OCT angiog...
Cited By1
Newest
Published on Jun 5, 2019
Navid Mohaghegh1
Estimated H-index: 1
,
Ebrahim Ghafar-Zadeh14
Estimated H-index: 14
,
Sebastian Magierowski9
Estimated H-index: 9
Recent advances of computerized graphical methods have received significant attention for detection and home monitoring of various visual distortions caused by macular disorders such as macular edema, central serous chorioretinopathy, and age-related macular degeneration. After a brief review of macular disorders and their conventional diagnostic methods, this paper reviews such graphical interface methods including computerized Amsler Grid, Preferential Hyperacuity Perimeter, and Three-dimensio...