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Purpose: The present study aims to determine the macular and choroidal optical coherence tomography angiography (OCTA) biomarkers in the assessment and monitoring of diabetic macular edema (DME) and diabetic macular ischemia (DMI) in patients with non?proliferative diabetic retinopathy (NPDR). Methods: In this cohort study, a total of 176 eyes of 110 patients with NPDR were investigated at our institute over a period of 10 months. Eyes were divided into four groups based on the severity of NPDR. Each eye was subjected to OCTA (Topcon 3D OCT?1 Maestro2) macula 6 × 6 mm2 en face. It features IMAGEnet 6 software for dynamic viewing of OCTA and imaging data. Four OCTA biomarkers for the macula were identified: foveal avascular zone area (FAZ area), foveal avascular zone contour irregularity (FAZ?CI), capillary dropout areas (CDA), and perifoveal intercapillary areas (PICA). The choroidal OCTA biomarker was the number of choroidal circulation flow voids (CCFV). For all analyses, P < 0.05 was considered statistically significant. Results: Increase in FAZ area and number of CDA were statistically significant (p < 0.0001) with an increase in central foveal thickness, suggesting a correlation of ischemic changes with an increase in DME. FAZ?CI, enlarged PICA, and CCFV were significantly associated with more severe NPDR patients. Conclusion: A correlation between DME and DMI in a patient of NPDR and its progression can be evaluated in a single visit. A unique feature of our study is it revealed novel diagnostic biomarkers of OCTA for DMI and DME.
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AIM: To evaluate the clinical effect of 25G pars plana vitrectomy(PPV)combined with dexamethasone intravitreal implant(DEX)on the treatment of vitreous hemorrhage and diabetic macular edema(DME)secondary to proliferative diabetic retinopathy(PDR).METHODS: Prospective clinical case study. A total of 40 patients(40 eyes)with vitreous hemorrhage and DME secondary to PDR who treated in Tianjin Eye Hospital from July 2020 to January 2022 were included in the study. All eyes underwent 25G PPV and cataract phacoemulsification. The patients were randomly divided into PPV group(20 eyes)and PPV+DEX group(20 eyes). Best corrected visual acuity(BCVA), intraocular pressure, and central macular thickness(CMT)of the patients before and 1, 3, 6mo after the operation were compared.RESULTS: All patients were followed up for 6mo. The BCVA of the patients in the PPV+DEX group improved better than that of the PPV group at 1, 3 and 6mo after surgery(P<0.05). CMT of the PPV+DEX group was lower than that of the PPV group at 1mo after operation(P<0.05). Retinal neovascularization or CMT regression with less than 5% was found in 8 eyes in the PPV group, who were supplemented with anti-vascular endothelial growth factor, while it was found in only 1 eye in the PPV+DEX group(P<0.05).CONCLUSION: PPV combined with DEX could yield synergies, which provide better therapeutic effect for the patients with vitreous hemorrhage and DME secondary to PDR.
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@#AIM: To observe the changes of retina superficial capillary plexus densities and aqueous humor factors in patients with diabetic macular edema(DME)before and after conbercept injection, and to explore the effect of conbercept on macular microcirculation in DME patients. <p>METHODS: A prospective case-control study was conducted. Totally 11 eyes of 10 patients diagnosed as DME in the Ophthalmology Department of the First Affiliated Hospital of Hainan Medical University from December 2019 to December 2020 were collected as DME group, 15 cataract patients without systemic basic diseases and fundus oculi diseases were collected as cataract group, and 20 age-and sex-matched healthy people with normal vision were collected as control group. All patients in DME group were treated by intravitreal injection of conbercept once a month for a total of 6 times. The retinal perfusion densities of the superficial capillary plexus(PSCP), retinal vessel densities of the superficial capillary plexus(VSCP), foveal avascular zone(FAZ), central macular thickness(CMT)and best corrected visual acuity(BCVA)were compared between the control group and DME patients before operation. The aqueous humor factors in cataract group and DME group were measured by multiplex flow immunoassay. The differences of aqueous humor factors in cataract group and DME group were compared. The changes of VSCP, PSCP, FAZ, CMT, BCVA and factors of aqueous humor in DME group after 6 conbercept injections were compared.<p>RESULTS: There were significant differences in PSCP, VSCP, FAZ area, BCVA and CMT between DME group and control group before operation(P<0.01); there were significant differences in angiopoietin-like protein 4(ANGPTL4), vascular endothelial growth factor(VEGF), interleukin-6(IL-6), interleukin-8(IL-8)in aqueous humor of DME group and cataract group before operation(P<0.001); PCSP and BCVA were increased and CMT were decreased in DME group after continuous conbercept injection for 6mo(all P<0.05); the concentrations of ANGPTL4, VEGF and IL-6 in aqueous humor of DME group decreased significantly(all P<0.05); patients injected with 1mo conbercept in the DME group had the most obvious improvement of BCVA and PSCP as well as the most obvious decline of CMT; while the ANGPTL4, VEGF and IL-6 in aqueous humor concentration had the most obvious decrease when they were injected with 1mo conbercept; VEGF in aqueous humor was positively correlated with the absolute value of CMT. <p>CONCLUSION: Conbercept injection in DME patients can improve retinal ischemia, reduce the concentration of VEGF and related factors in aqueous humor, effectively increase BCVA and relieve macular edema.
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Introduction: To investigate the correlation between Macular thickness and Volume with Bestcorrected visual acuity (BCVA) in eyes with Diabetic macular edema and Type 2 diabetes. Materials and Methods: A retrospective study including 60 eyes of 60 patients evaluating Retinal thickness and macular volume measured with Spectral Domain Optical Coherence Tomography and best corrected visual acuity was measured with the Snellens Chart. Results: There is significant increase in the macular thickness and macular volume with decrease in the best corrected visual acuity. Conclusion: Diabetic macular edema causes decrease in visual acuity due increase in macular thickness and volume.
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PURPOSE: To evaluate the peripapillary retinal nerve fiber layer (pRNFL) thickness and macular ganglion cell-inner plexiform layer (mGCIPL) thickness in eyes with resolved diabetic macular edema (DME). METHODS: Twenty eyes of diabetic retinopathy patients with resolved DME (DME group) after treatment, and 20 eyes of diabetic retinopathy patients without DME (no-DME group) were included in this study. The pRNFL thickness, mGCIPL thickness and central macular thickness (CMT) were measured using spectral-domain optical coherence tomography (SD-OCT). Analyses were performed to determine the correlation between the different thicknesses and the visual function. RESULTS: No significant difference in mean CMT was observed between the DME and no-DME groups. Average pRNFL thickness in the DME group was thicker than in the no-DME group (p = 0.003). Average mGCIPL thickness in the DME group was thinner than in the no-DME group (p = 0.030). Final visual acuity was significantly correlated with average mGCIPL thickness and minimum mGCIPL thickness, but not pRNFL thickness and CMT in the DME group. CONCLUSIONS: mGCIPL thickness decreased in the DME group compared with the no-DME group and was correlated with the visual acuity. These results suggested that inner retinal injury in patients with DME might lead to poor visual outcome after treatment.