Morphological changes of foveal cysts as a predictor for visual response to anti-vascular endothelial growth factor treatments in diabetic macular edema: Degenerative cyst in DME

Purpose To investigate morphological changes of intraretinal cyst in association with visual acuity following treatment for diabetic macular edema. Methods This retrospective study enrolled 105 eyes from 105 treatment naïve patients with diabetic macular edema following anti-vascular endothelial gro...

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Bibliographic Details
Published in:International ophthalmology 2023-08, Vol.43 (8), p.2751-2762
Main Authors: Tsai, Meng-Ju, Cheng, Cheng-Kuo
Format: Article
Language:English
Subjects:
Angiogenesis Inhibitors - therapeutic use
Diabetes Mellitus
Diabetic Retinopathy - complications
Diabetic Retinopathy - diagnosis
Diabetic Retinopathy - drug therapy
Endothelial Growth Factors - therapeutic use
Humans
Intravitreal Injections
Macular Edema - diagnosis
Macular Edema - drug therapy
Macular Edema - etiology
Medicine
Medicine & Public Health
Ophthalmology
Original Paper
Ranibizumab - therapeutic use
Retrospective Studies
Tomography, Optical Coherence - methods
Vascular Endothelial Growth Factor A
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Summary:Purpose To investigate morphological changes of intraretinal cyst in association with visual acuity following treatment for diabetic macular edema. Methods This retrospective study enrolled 105 eyes from 105 treatment naïve patients with diabetic macular edema following anti-vascular endothelial growth factor injections. Best-corrected visual acuity (BCVA) and optical coherence tomography (OCT) data were obtained at baseline, 1, 3, 6, and 12 months. The width and height of the largest intraretinal cyst (IRC) at all different visits were measured and were correlated to final visual acuity by receiver operating characteristic curve. The exudative feature was defined by the presence of hard exudates. Multivariate logistic regression was used to select the independent predictor for visual outcomes. Results Intraretinal cyst width but not the cyst height after treatment at 1 month independently predicted final visual loss of ten letters or more (multivariate P  = 0.009). The optimal cutoff value was 196 um with a sensitivity of 0.889 and a specificity of 0.656. Eyes with large IRC width using this cutoff were consistently larger than those with small IRC width through 12 months ( P  = 0.008, Mann–Whitney U test). Small IRC width 
ISSN:1573-2630
1573-2630
DOI:10.1007/s10792-023-02674-6