Prospective study of morphologic and functional parameter changes post intravitreal therapy for macular edema.

Abstract

PURPOSE:

Retinal sensitivity (RS) can be a valuable indicator of retinal function in response to intravitreal steroid or anti-VEGF treatment in the eyes with diabetic macular edema (DME), macular edema post retinal vein occlusion (RVO), or uveitis.

METHODS:

This prospective longitudinal study included 68 patients (96 eyes) with macular edema (ME) secondary to diabetes mellitus (42 eyes), uveitis (36 eyes), or RVO (18 eyes). In addition to best corrected visual acuity (BCVA) and retinal thickness, Nidek MP1 microperimetry was used to quantify RS at baseline visit and to look at the mean difference (MD) at 3-6 months and 1-2 years post intravitreal therapy with corticosteroids or anti-VEGF.

RESULTS:

There was a significant negative correlation between the central RS and BCVA (r = - 0.47, p < 0.001), including DME (r = - 0.42, p = 0.006) and uveitis (r = - 0.60, p < 0.001), but not RVO (r = - 0.37, p = 0.12). At 2-year follow-up, the overall CST was reduced from baseline (MD - 147 μm, 95% C.I - 192 to - 102, p < 0.001) with improved BCVA (MD - 0.12 LogMAR, 95% C.I - 0.23 to - 0.01, p = 0.01), but no improvement in the RS in any of the disorders. Both anti-VEFG and steroid groups showed significant improvement in CST at 2 years from baseline (MD - 101 μm, p = 0.001 and - 167 μm, p < 0.001, respectively) with only improvement in BCVA among anti-VEGF group (MD - 0.16 LogMAR, 95% C.I - 0.26 to - 0.07, p = 0.008).

CONCLUSION:

The long-term follow-up of ME cases did not show a significant improvement in RS following treatment even with reduced macular thickness at 2-year follow-up.

• Authors: Lazha Sharief, Yi-Hsing Chen, Sue Lightman, Oren Tomkins-Netzer
• Journal: Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie (Graefes Arch Clin Exp Ophthalmol) Vol. 258 Issue 9 Pg. 1941-1947 (Sep 2020) ISSN: 1435-702X [Electronic] Germany
• PMID: 32361803 (Publication Type: Journal Article)

Chemical References

• Angiogenesis Inhibitors
• Glucocorticoids
• Vascular Endothelial Growth Factor A

Topics

• Adult
• Aged
• Aged, 80 and over
• Angiogenesis Inhibitors (administration & dosage)
• Female
• Follow-Up Studies
• Glucocorticoids (administration & dosage)
• Humans
• Intravitreal Injections
• Macula Lutea (pathology)
• Macular Edema (diagnosis, drug therapy, physiopathology)
• Male
• Middle Aged
• Prospective Studies
• Tomography, Optical Coherence
• Treatment Outcome
• Vascular Endothelial Growth Factor A (antagonists & inhibitors)
• Visual Acuity
• Young Adult