Evaluation of ischemic diabetic maculopathy with Fourier-domain optical coherence tomography and microperimetry.

OBJECTIVE: To evaluate the efficacy of high-speed Fourier-domain optical coherence tomography (FD-OCT) and fundus microperimetry (MP-1) in identifying the anatomic and functional features of ischemic diabetic maculopathy. DESIGN: Prospective noninterventional study. PARTICIPANTS: Forty-two consecutive eyes (23 patients) with ischemic diabetic maculopathy and 40 normal eyes (25 control subjects) were included in this study. METHODS: Best corrected visual acuity, ganglion cell complex (GCC) thickness measured with FD-OCT, and central light sensitivity recorded with MP-1 were evaluated. RESULTS: GCC thickness and light sensitivity were significantly reduced in all affected eyes versus control eyes. logMAR BVCA was significantly correlated with mean macular sensitivity (R=0.783, R(2)=0.611). CONCLUSIONS: GCC thickness and microperimetry integrated with fluorescein angiography could be a marker of retinal vascular abnormalities that is useful for the diagnosis of ischemic diabetic maculopathy.

Functional and anatomic changes in bilateral choroidal neovascularization associated with vitelliform macular dystrophy after intravitreal bevacizumab.

PURPOSE: We report the case of a young man with choroidal neovascularization (CNV) associated with vitelliform macular dystrophy (Best's disease), who underwent treatment with intravitreal bevacizumab. CASE: A 17-year-old white male presented for a routine ocular examination after reduction of visual acuity and was diagnosed with CNV in both eyes secondary to Best's disease. The diagnosis was confirmed by an ophthalmologic examination that included fluorescein angiography, indocyanine green angiography, Fourier optical coherence tomography, and microperimetry. Best corrected visual acuity was 5/10 in the right eye and 6/10 in the left eye. An intravitreal injection of bevacizumab was administered in both eyes. RESULTS: One month after bevacizumab injection, vision was 10/10 in both eyes. At a follow-up of 18 months, there was an absence of the neovascularization activity, and microperimetry revealed a marked improvement in retinal macular sensitivity. CONCLUSION: Intravitreal bevacizumab injection induced total regression of CNV as well as a morphologic and functional improvement in a young man affected by bilateral CNV secondary to Best's disease in a long-term follow-up.

Functional and anatomic response of the retina and the choroid to intravitreal bevacizumab for macular edema.

PURPOSE: This study evaluated the rate of change of best corrected visual acuity (BCVA), central retinal sensitivity, and retinal and choroidal thickness in patients with macular edema after intravitreal bevacizumab. METHODS: This was a prospective, nonrandomized, interventional study. Thirty-four consecutive eyes (34 patients) with macular edema were included in the study. Choroidal neovascularization was present in 21 cases, stage 1 retinal angiomatous proliferation in 6 cases, branch retinal vein occlusion in 4 cases, and diabetic edema in 3 cases. Evaluation of BCVA (Early Treatment Diabetic Retinopathy Study [ETDRS] logarithm of the minimum angle of resolution [LogMAR]), central retinochoroidal thickness (RCT) at standardized A-scan, combined optical coherence tomography/microperimetric assessment of central retinal thickness (RT), central scotoma, and fixation behavior was performed during 12 months after treatment. Choroidal thickness was considered as the difference between RCT and RT. All patients received two initial intravitreal bevacizumab injections (1.25 mg/0.05 mL) at a 1-month interval. RESULTS: BCVA and RT during follow-up were significantly better than at baseline. BCVA was improved of 0.32±0.3 LogMAR (P<0.001) at month 1, 0.18±0.4 LogMAR (P=0.05) at month 6, and 0.14±0.2 (P=0.09) at month 12. RT was reduced by 172.9±192.8 µm (P<0.001) at month 1, 157.7±134.2 µm (P=0.003) at month 6, and 164.3±122.3 (P=0.002) at month 12. Mean retinal sensitivity significantly increased during the first month; it decreased afterward, but an improvement if compared with baseline was present at each visit during follow-up. In 23.5% of cases, a choroidal thinning was present during follow-up, and in this group visual acuity at baseline and final visual improvement were significantly greater if compared with patients showing a choroidal thickening. CONCLUSION: Intravitreal bevacizumab for macular edema determines significant functional and anatomic improvement at the 12-month follow-up. Visual acuity at baseline and following treatment could be influenced by the choroidal involvement.

Bevacizumab in macular edema: functional and anatomic changes in a prospective case series.

OBJECTIVE: To evaluate the early rate of change of best-corrected visual acuity (BCVA), central retinal sensitivity, neuroretinal and choroidal thickness in patients with macular edema after 1.25 mg/0.05 ml intravitreal bevacizumab (Avastin; Genentech, Inc., South San Francisco, CA). METHODS: A prospective, nonrandomized, interventional study. Thirty-seven consecutive eyes with macular edema were included in the study. For all eyes, BCVA, central retinochoroidal thickness at standardized A-scan, central retinal thickness, and central retinal sensitivity recorded with a spectral scanning laser ophthalmoscope optical coherence tomography/microperimeter device were evaluated at baseline and 7, 15, 30, 37, 45, and 60 days after initial treatment. All patients received 2 intravitreal bevacizumab injections at 1-month interval. RESULTS: A significant although not related improvement of BCVA and retinal sensitivity was seen after 1 month and 2 months of follow-up. Anatomic improvement only involved the neuroretina, although significant changes of central choroidal thickness were not detected. CONCLUSION: Intravitreal bevacizumab for macular edema determines significant early functional and anatomic improvements.