Imaging features of weak response to anti-VEGF therapy for refractory DME with vesicles / 西安交通大学学报(医学版)

ABSTRACT

【Objective】 To investigate the imaging features of weak response after anti-vascular endothelial growth factor (VEGF) treatment for refractory diabetic macular edema (DME) with vesicles. 【Methods】 We made a retrospective analysis of the clinical data of 120 patients with DME (120 eyes) who received anti-VEGF therapy in Ophthalmology Department of The Second Affiliated Hospital of Xi’an Jiaotong University from March 2018 to September 2019 and the same anti-VEGF medicine with the therapeutic regimen of 3+PRN. Of the 50 patients with cystoid macular edema (CME), 40 of them had a significant response and 10 had a weak response. The characteristics of optical coherence tomography (OCT) and fundus fluorescein angiography (FFA) for the patients with weak response after anti-VEGF therapy were comparatively analyzed. 【Results】 Eyes with vesicular DME that responded weakly to anti-VEGF treatment had similar imaging characteristics. The OCT images showed impurity-independent vesicles located in the inner layer of the retina. Compared with the obvious response group, the reflection signal of the vesicle area was significantly enhanced. In early images of FFA, micro-angiomas related to vesicle formation were seen in both groups. However, in the late FFA image, the leakage intensity of vesicles in the weak response group was significantly lower than that in the obvious response group. 【Conclusion】 Vesicular DME with poor anti-VEGF treatment has the characteristics of high reflection in OCT and weak fluorescence leakage in FFA. This study is helpful for preoperative evaluation of anti-VEGF treatment.