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Comparison of clinical outcomes of different components of diabetic macular edema on optical coherence tomography

  • Retinal Disorders
  • Published:
Graefe's Archive for Clinical and Experimental Ophthalmology Aims and scope Submit manuscript

Abstract

Purpose

To evaluate the edema reduction after intravitreal injection of ranibizumab (IVR) in two diabetic macular edema (DME) components in the same eye using optical coherence tomography (OCT).

Methods

Totally 113 eyes with mixed OCT pattern of DME were included. All the eyes underwent best-corrected visual acuity (BCVA) examination and OCT scanning at baseline and follow-up visits (1, 3, and 6 months after 3 monthly consecutive IVR). The mixed OCT pattern of DME was classified into 2 OCT components: serous retinal detachment (SRD) component and non-SRD component. Foveal thickness of the SRD component (SRDFT) and the non-SRD component (NSRDFT) was compared between baseline and follow-up visits. Reduction and reduction ratio of the SRDFT and the NSRDFT at each follow-up were compared. When calculating the NSRDFT reduction ratio, we innovatively optimized a commonly used formula by subtracting the normal foveal thickness from the baseline NSRDFT.

Results

SRDFT was 265.6 ± 175.4 μm at baseline and was significantly decreased to 126.7 ± 114.4 μm at 1 month, to 110.5 ± 103.4 μm at 3 months, and to 110.4 ± 89.6 μm at 6 months (all P < 0.001). NSRDFT was 409.5 ± 173.1 μm at baseline and was significantly decreased to 274.1 ± 140.4 μm at 1 month, to 249.1 ± 95.9 μm at 3 months, and to 254.1 ± 90.4 μm at 6 months (all P < 0.001). There was no significant difference in reduction or reduction ratio between NSRDFT and SRDFT during follow-up (all P > 0.05). The correlation between BCVA and SRDFT was most significant at baseline (r = 0.366, P < 0.001) and the correlation between BCVA and NSRDFT was most significant at 6 months (r = 0.426, P < 0.001). BCVA improvement was more significantly correlated with reduction or reduction ratio of SRDFT at each follow-up timepoint (r = 0.271–0.426, all P < 0.01).

Conclusions

IVR was effective in reducing both the SRD and non-SRD components of DME according to our optimized formula. The association between BCVA improvement and edema reduction was more significant in the SRD component.

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References

  1. Otani T, Kishi S, Maruyama Y (1999) Patterns of diabetic macular edema with optical coherence tomography. Am J Ophthalmol 127:688–693

    Article  CAS  PubMed  Google Scholar 

  2. Kim BY, Smith SD, Kaiser PK (2006) Optical coherence tomographic patterns of diabetic macular edema. Am J Ophthalmol 142:405–412. https://doi.org/10.1016/j.ajo.2006.04.023

    Article  PubMed  Google Scholar 

  3. Seo KH, Yu SY, Kim M, Kwak HW (2016) Visual and morphologic outcomes of intravitreal ranibizumab for diabetic macular edema based on optical coherence tomography patterns. Retina 36:588–595. https://doi.org/10.1097/iae.0000000000000770

    Article  CAS  PubMed  Google Scholar 

  4. Giocanti-Auregan A, Hrarat L, Qu LM, Sarda V, Boubaya M, Levy V, Chaine G, Fajnkuchen F (2017) Functional and anatomical outcomes in patients with serous retinal detachment in diabetic macular edema treated with ranibizumab. Invest Ophthalmol Vis Sci 58:797–800. https://doi.org/10.1167/iovs.16-20855

    Article  CAS  PubMed  Google Scholar 

  5. Yanoff M, Fine BS, Brucker AJ, Eagle RC Jr (1984) Pathology of human cystoid macular edema. Surv Ophthalmol 28:505–511

    Article  PubMed  Google Scholar 

  6. Kaya M, Kaya D, Idiman E, Kocak N, Ozturk T, Ayhan Z, Altun Z, Kaynak S (2019) A novel biomarker in diabetic macular edema with serous retinal detachment: serum chitinase-3-like protein 1. Ophthalmologica 241:90–97. https://doi.org/10.1159/000490534

    Article  CAS  PubMed  Google Scholar 

  7. Vujosevic S, Torresin T, Berton M, Bini S, Convento E, Midena E (2017) Diabetic macular edema with and without subfoveal neuroretinal detachment: two different morphologic and functional entities. Am J Ophthalmol 181:149–155. https://doi.org/10.1016/j.ajo.2017.06.026

    Article  PubMed  Google Scholar 

  8. Daruich A, Matet A, Moulin A, Kowalczuk L, Nicolas M, Sellam A, Rothschild PR, Omri S, Gelize E, Jonet L, Delaunay K, De Kozak Y, Berdugo M, Zhao M, Crisanti P, Behar-Cohen F (2018) Mechanisms of macular edema: beyond the surface. Prog Retin Eye Res 63:20–68. https://doi.org/10.1016/j.preteyeres.2017.10.006

    Article  PubMed  Google Scholar 

  9. Sophie R, Lu N, Campochiaro PA (2015) Predictors of functional and anatomic outcomes in patients with diabetic macular edema treated with ranibizumab. Ophthalmology 122:1395–1401. https://doi.org/10.1016/j.ophtha.2015.02.036

    Article  PubMed  Google Scholar 

  10. Mitchell P, Bandello F, Schmidt-Erfurth U, Lang GE, Massin P, Schlingemann RO, Sutter F, Simader C, Burian G, Gerstner O, Weichselberger A (2011) The RESTORE study: ranibizumab monotherapy or combined with laser versus laser monotherapy for diabetic macular edema. Ophthalmology 118:615–625. https://doi.org/10.1016/j.ophtha.2011.01.031

    Article  PubMed  Google Scholar 

  11. Shimura M, Yasuda K, Yasuda M, Nakazawa T (2013) Visual outcome after intravitreal bevacizumab depends on the optical coherence tomographic patterns of patients with diffuse diabetic macular edema. Retina 33:740–747. https://doi.org/10.1097/IAE.0b013e31826b6763

    Article  CAS  PubMed  Google Scholar 

  12. Shimura M, Yasuda K, Nakazawa T, Hirano Y, Sakamoto T, Ogura Y, Shiono T (2011) Visual outcome after intravitreal triamcinolone acetonide depends on optical coherence tomographic patterns in patients with diffuse diabetic macular edema. Retina 31:748–754. https://doi.org/10.1097/IAE.0b013e3181f04991

    Article  PubMed  Google Scholar 

  13. Kaya M, Karahan E, Ozturk T, Kocak N, Kaynak S (2018) Effectiveness of intravitreal ranibizumab for diabetic macular edema with serous retinal detachment. Korean J Ophthalmol 32:296–302. https://doi.org/10.3341/kjo.2017.0117

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  14. Liu Q, Hu Y, Yu H, Yuan L, Hu J, Atik A, Guan M, Li D, Li X, Tang S (2015) Comparison of intravitreal triamcinolone acetonide versus intravitreal bevacizumab as the primary treatment of clinically significant macular edema. Retina 35:272–279. https://doi.org/10.1097/iae.0000000000000300

    Article  CAS  PubMed  Google Scholar 

  15. Kim NR, Kim YJ, Chin HS, Moon YS (2009) Optical coherence tomographic patterns in diabetic macular oedema: prediction of visual outcome after focal laser photocoagulation. Br J Ophthalmol 93:901–905. https://doi.org/10.1136/bjo.2008.152553

    Article  CAS  PubMed  Google Scholar 

  16. Lee J, Moon BG, Cho AR, Yoon YH (2016) Optical coherence tomography angiography of DME and its association with anti-VEGF treatment response. Ophthalmology 123:2368–2375. https://doi.org/10.1016/j.ophtha.2016.07.010

    Article  PubMed  Google Scholar 

  17. Duan XR, Liang YB, Friedman DS, Sun LP, Wong TY, Tao QS, Bao L, Wang NL, Wang JJ (2010) Normal macular thickness measurements using optical coherence tomography in healthy eyes of adult Chinese persons: the Handan Eye Study. Ophthalmology 117:1585–1594. https://doi.org/10.1016/j.ophtha.2009.12.036

    Article  PubMed  Google Scholar 

  18. Das A, McGuire PG, Rangasamy S (2015) Diabetic macular edema: pathophysiology and novel therapeutic targets. Ophthalmology 122:1375–1394. https://doi.org/10.1016/j.ophtha.2015.03.024

    Article  PubMed  Google Scholar 

  19. Klaassen I, Van Noorden CJ, Schlingemann RO (2013) Molecular basis of the inner blood-retinal barrier and its breakdown in diabetic macular edema and other pathological conditions. Prog Retin Eye Res 34:19–48. https://doi.org/10.1016/j.preteyeres.2013.02.001

    Article  CAS  PubMed  Google Scholar 

  20. Koytak A, Altinisik M, Sogutlu Sari E, Artunay O, Umurhan Akkan JC, Tuncer K (2013) Effect of a single intravitreal bevacizumab injection on different optical coherence tomographic patterns of diabetic macular oedema. Eye (Lond) 27:716–721. https://doi.org/10.1038/eye.2013.17

    Article  CAS  Google Scholar 

  21. Bressler SB, Odia I, Maguire MG, Dhoot DS, Glassman AR, Jampol LM, Marcus DM, Solomon SD, Sun JK (2019) Factors associated with visual acuity and central subfield thickness changes when treating diabetic macular edema with anti-vascular endothelial growth factor therapy: an exploratory analysis of the protocol T randomized clinical trial. JAMA Ophthalmol. https://doi.org/10.1001/jamaophthalmol.2018.6786

    Article  PubMed  PubMed Central  Google Scholar 

  22. Zur D, Iglicki M, Busch C, Invernizzi A, Mariussi M, Loewenstein A, Busch C, Cebeci Z, Chhablani JK, Chaikitmongkol V, Couturier A, Fraser-Bell S, Giancipoli E, Iglicki M, Invernizzi A, Laíns I, Loewenstein A, Lupidi M, Rehak M, Rodriguez P, Mendes TS, Sala-Puigdollers A, Zur D (2018) OCT biomarkers as functional outcome predictors in diabetic macular edema treated with dexamethasone implant. Ophthalmology 125:267–275. https://doi.org/10.1016/j.ophtha.2017.08.031

    Article  PubMed  Google Scholar 

  23. Hillier RJ, Ojaimi E, Wong DT, Mak MYK, Berger AR, Kohly RP, Kertes PJ, Forooghian F, Boyd SR, Eng K, Altomare F, Giavedoni LR, Nisenbaum R, Muni RH (2018) Aqueous humor cytokine levels and anatomic response to intravitreal ranibizumab in diabetic macular edema. JAMA Ophthalmol 136. https://doi.org/10.1001/jamaophthalmol.2018.0179

    Article  PubMed  PubMed Central  Google Scholar 

  24. Gaucher D, Sebah C, Erginay A, Haouchine B, Tadayoni R, Gaudric A, Massin P (2008) Optical coherence tomography features during the evolution of serous retinal detachment in patients with diabetic macular edema. Am J Ophthalmol 145:289–296. https://doi.org/10.1016/j.ajo.2007.09.029

    Article  PubMed  Google Scholar 

  25. K-GDS N (2009) Assessment of serous macular detachment in eyes with diabetic macular edema by use of spectral-domain optical coherence tomography. Graefes Arch Clin Exp Ophthalmol 247:1461–1469. https://doi.org/10.1007/s00417-009-1124-4

    Article  Google Scholar 

  26. HJ S, SH L, H C HCK (2012) Association between photoreceptor integrity and visual outcome in diabetic macular edema. Graefes Arch Clin Exp Ophthalmol 250:61–70. https://doi.org/10.1007/s00417-011-1774-x

    Article  Google Scholar 

  27. F F, PF S, SA M, EY C, WT W, C C, CB M, Ferris FL (2010) Relationship between photoreceptor outer segment length and visual acuity in diabetic macular edema. Retina 30:63–70. https://doi.org/10.1097/IAE.0b013e3181bd2c5a

    Article  Google Scholar 

Download references

Funding

This study was funded by the National Natural Science Foundation of China (Grant Number 81870663) and Talent Introduction Fund of Guangdong Provincial People’s Hospital (Grant Number Y012018145).

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Authors and Affiliations

  1. Guangdong Eye Institute, Department of Ophthalmology, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences; School of Medicine, South China University of Technology, Guangzhou, China

    Yijun Hu, Qiaowei Wu, Baoyi Liu, Dan Cao, Xinran Dong, Liang Zhang, Xiaohong Yang & Honghua Yu

  2. Aier School of Ophthalmology, Central South University, Changsha, China

    Yijun Hu

  3. The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China

    Qiaowei Wu & Baoyi Liu

  4. State Key Laboratory of Ophthalmology, Clinical Research Center for Ocular Disease, Zhongshan Ophthalmic Centre, Sun Yat-sen University, Guangzhou, China

    Tao Li

Authors
  1. Yijun Hu
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  2. Qiaowei Wu
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  4. Dan Cao
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  9. Honghua Yu
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Contributions

Yijun Hu, Qiaowei Wu, and Baoyi Liu contributed equally to the article. Thanks to Xiaohong Yang and Tao Li for their design, analysis, and interpretation of the data, so they are considered as co-corresponding authors.

Corresponding author

Correspondence to Honghua Yu.

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Conflict of interest

The authors declare that they have no conflicts of interest.

Ethical approval

All procedures performed in our study were in accordance with the ethical standards of the Research Ethics Committee of Guangdong Provincial People’s Hospital and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. For this type of study, informed consent is not required.

Informed consent

Since the study is about the outcomes of a standard treatment of DME and no individual patient could be identified from the data, formal informed consent was waived.

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Hu, Y., Wu, Q., Liu, B. et al. Comparison of clinical outcomes of different components of diabetic macular edema on optical coherence tomography. Graefes Arch Clin Exp Ophthalmol 257, 2613–2621 (2019). https://doi.org/10.1007/s00417-019-04471-3

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  • DOI: https://doi.org/10.1007/s00417-019-04471-3

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