Abstract
Purpose
The aim of this study is to compare the therapeutic effect of a single intravitreal bevacizumab (IVB) injection in eyes with diabetic macular oedema (DMO) of different patterns determined by optical coherence tomography (OCT).
Methods
Medical records of patients who had a single IVB injection for DMO were analysed retrospectively. Eyes with a clinically significant DMO and a central foveal thickness (CFT) of 250 μm or more determined by OCT were included in the analysis. Best-corrected visual acuity (BCVA), CFT and total macular volume values before and after the injection were recorded. Eyes were divided into sponge-like diffuse retinal thickening (DRT), cystoid macular oedema (CMO) and serous retinal detachment (SRD) groups according to the morphology on OCT.
Results
A total of 92 eyes (42 with DRT, 31 with CMO and 19 with SRD) were included in the study. There was no statistically significant variation between three groups regarding the change in BCVA (P=0.695). CMO and SRD groups had greater reductions in their mean CFT, and the amount of reduction showed statistically significant variation between three groups (P=0.048). However, no statistically significant difference was found between groups in terms of percentage of change in CFT (P=0.278).
Conclusion
CMO and SRD subtypes are associated with a greater reduction in the CFT than the DRT subtype. Although the change in BCVA was not significantly different between groups, the DRT group showed markedly better visual improvement in proportion to the decrease in CFT.
Similar content being viewed by others
Log in or create a free account to read this content
Gain free access to this article, as well as selected content from this journal and more on nature.com
or
References
Do Carmo A, Ramos P, Reis A, Proença R, Cunha-Vaz JG . Breakdown of the inner and outer blood retinal barrier in streptozotocin induced diabetes. Exp Eye Res 1998; 67: 569–175.
Sander B, Larsen M, Moldow B, Lund-Anderson H . Diabetic macular edema: passive and active transport of fluorescein through the blood-retina barrier. Invest Ophthalmol Vis Sci 2001; 42: 433–438.
Tso MO, Cunha-Vaz JG, Shih CY, Jones CW . Clinicopathologic study of blood-retinal barrier in experimental diabetes mellitus. Arch Ophthalmol 1980; 98: 2032–2040.
Bhagat N, Grigorian RA, Tutela A, Zarbin MA . Diabetic macular edema: pathogenesis and treatment. Surv Ophthalmol 2009; 54: 1–32.
Hee MR, Puliafito CA, Wong C, Duker JS, Reichel E, Rutledge B et al. Quantitative assessment of macular edema with optical coherence tomography. Arch Ophthalmol 1995; 113: 1019–1029.
Hee MR, Puliafito CA, Duker JS, Reichel E, Coker JG, Wilkins JR et al. Topography of diabetic macular edema with optical coherence tomography. Ophthalmology 1998; 105: 360–370.
Otani T, Kishi S, Maruyama Y . Patterns of diabetic macular edema with optical coherence tomography. Am J Ophthalmol 1999; 127: 688–693.
Kim BY, Smith SD, Kaiser PK . Optical coherence tomographic patterns of diabetic macular edema. Am J Ophthalmol 2006; 142: 405–412.
Yanoff M, Fine BS, Brucker AJ, Eagle RC . Pathology of human cystoid macular edema. Surv Ophthalmol 1984; 28 (Suppl): 505–511.
Fine BS, Brucker AJ . Macular edema and cystoid macular edema. Am J Ophthalmol 1981; 92: 466–481.
Tso MO . Pathology of cystoid macular edema. Ophthalmology 1982; 89: 902–915.
Early Treatment Diabetic Retinopathy Study Research Group. Photocoagulation for diabetic macular edema. Early treatment diabetic retinopathy study report number 1. Arch Ophthalmol 1985; 103: 1796–1806.
Kim NR, Kim YJ, Chin HS, Moon YS . Optical coherence tomographic patterns in diabetic macular oedema: prediction of visual outcome after focal laser photocoagulation. Br J Ophthalmol 2009; 93: 901–905.
Lee CM, Olk RJ . Modified grid laser photocoagulation for diffuse diabetic macular edema. Long-term visual results. Ophthalmology 1991; 98: 1594–1602.
Shulman S, Ferencz JR, Gilady G, Ton Y, Assia E . Prognostic factors for visual acuity improvement after intravitreal triamcinolone injection. Eye 2007; 21: 1067–1070.
Shimura M, Yasuda K, Nakazawa T, Hirano Y, Sakamoto T, Ogura Y et al. Visual outcome after intravitreal triamcinolone acetonide depends on optical coherence tomographic patterns in patients with diffuse diabetic macular edema. Retina 2011; 31: 748–754.
Roh MI, Kim JH, Kwon OW . Features of optical coherence tomography are predictive of visual outcomes after intravitreal bevacizumab injection for diabetic macular edema. Ophthalmologica 2010; 224: 374–380.
Kim M, Lee P, Kim Y, Yu SY, Kwak HW . Effect of intravitreal bevacizumab based on optical coherence tomography patterns of diabetic macular edema. Ophthalmologica 2011; 226: 138–144.
Arevalo JF, Sanchez JG, Wu L, Maia M, Alezzandrini AA, Brito M et alPan-American Collaborative Retina Study Group. Primary intravitreal bevacizumab for diffuse diabetic macular edema: the Pan-American Collaborative Retina Study Group at 24 months. Ophthalmology 2009; 116: 1488–1497.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Competing interests
The authors declare no conflict of interest.
Rights and permissions
About this article
Cite this article
Koytak, A., Altinisik, M., Sogutlu Sari, E. et al. Effect of a single intravitreal bevacizumab injection on different optical coherence tomographic patterns of diabetic macular oedema. Eye 27, 716–721 (2013). https://doi.org/10.1038/eye.2013.17
Received:
Accepted:
Published:
Issue date:
DOI: https://doi.org/10.1038/eye.2013.17
Keywords
This article is cited by
-
Comparison of intravitreal ranibizumab and aflibercept for the treatment of diabetic macular edema: a real-world study
International Ophthalmology (2023)
-
Association between the patterns of diabetic macular edema and photoreceptors’ response after intravitreal ranibizumab treatment: a spectral-domain optical coherence tomography study
International Ophthalmology (2020)
-
Baseline SD-OCT characteristics of diabetic macular oedema patterns can predict morphological features and timing of recurrence in patients treated with dexamethasone intravitreal implants
Acta Diabetologica (2020)
-
Intravitreal dexamethasone implant Ozurdex® in naïve and refractory patients with different subtypes of diabetic macular edema
BMC Ophthalmology (2019)
-
Factors influencing clinical outcomes in patients with diabetic macular edema treated with intravitreal ranibizumab: comparison between responder and non-responder cases
Scientific Reports (2019)
