Response to: Choroidal thickness changes stratified by outcome in real-world treatment of diabetic macular edema

  • António CamposEmail author
  • Elisa J. Campos
  • Anália do Carmo
  • Rufino Silva
Letter to the Editor (by invitation)

Dear Editor,

We thank Călugăru et al. for their interest in our report about the role of the mean baseline subfoveal choroidal thickness (SFCT), as a predictor of outcome in real-world treatment of diabetic macular edema (DME).

Here are our answers, point by point:
  1. 1.

    The authors considered the following, as possible bias, in our study, (i) about half of the population had past laser history; (ii) different forms of non-proliferative diabetic retinopathy (NPDR) were included; (iii) the eyes that developed proliferative diabetic retinopathy, the eyes that were rescued by laser or switched to steroids were excluded from the follow-up, and (iv) 13 eyes were treated with aflibercept.

  2. 2.

    Previously, we stated that it is under dispute how choroidal thickness (CT) changes with the NPDR staging, but not with the anti-VEGF use, in any form of NPDR [1]. Supplementary Fig. 2 depicts that differences in CT regarding past laser history were not significant. Outcome calculations were done at...


  1. 1.
    Campos A, Campos EJ, Martins J, Ambrósio AF, Silva R (2017) Viewing the choroid: where we stand, challenges and contradictions in diabetic retinopathy and diabetic macular oedema. Acta Ophthalmol 95:446–459. CrossRefGoogle Scholar
  2. 2.
    Diabetic Retinopathy Clinical Research Network, Wells JA, Glassman AR, Ayala AR, Jampol LM, Aiello LP et al (2015) Aflibercept, bevacizumab, or ranibizumab for diabetic macular edema. N Engl J Med 372:1193–1203. CrossRefGoogle Scholar
  3. 3.
    Sivaprasad S, Regnier SA, Fajnkuchen F, Wright J, Berger AR, Mitchell P, Larsen M (2016) Using patient-level data to develop meaningful cross-trial comparisons of visual impairment in individuals with diabetic macular edema. Adv Ther 33:597–609. CrossRefGoogle Scholar
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    Regnier S, Malcolm W, Allen F, Wright J, Bezlyak V (2014) Efficacy of anti-VEGF and laser photocoagulation in the treatment of visual impairment due to diabetic macular edema: a systematic review and network meta-analysis. PLoS One 9:e102309. CrossRefGoogle Scholar
  5. 5.
    Santos AR, Costa MA, Schwartz C, Alves D, Figueira J, Silva R, Cunha-Vaz JG (2018) Optical coherence tomography baseline predictors for initial best-corrected visual acuity response to intravitreal anti-vascular endothelial growth factor treatment in eyes with diabetic macular edema: the CHARTRES study. Retina 38:1110–1119. CrossRefGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Coimbra Institute for Clinical and Biomedical Research (iCBR), Faculty of MedicineUniversity of CoimbraCoimbraPortugal
  2. 2.CNC.IBILI ConsortiumUniversity of CoimbraCoimbraPortugal
  3. 3.Department of OphthalmologyLeiria HospitalLeiriaPortugal
  4. 4.Clinical Pathology DepartmentCentro Hospitalar e Universitário de Coimbra (CHUC)CoimbraPortugal
  5. 5.Department of OphthalmologyCentro Hospitalar e Universitário de Coimbra (CHUC)CoimbraPortugal
  6. 6.Association for Innovation and Biomedical Research on Light and Image (AIBILI)CoimbraPortugal

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