Osama A Sorour1,2, Mohamed Elsheikh3,4, Siyu Chen5, Ayman G Elnahry6, Caroline R Baumal2, Varsha Pramil2, Tamer I Abdelhalim1, Elsayed Nassar1, Eric M Moult5, Andre J Witkin2, Jay S Duker2, Nadia K Waheed2. 1. Department of Ophthalmology, Faculty of Medicine, Tanta University, Tanta, Egypt. 2. New England Eye Center, Tufts Medical Center, Tufts University, Boston, Massachusetts, USA. 3. Department of Geomatics Engineering, University of Calgary, Calgary, Canada. 4. Department of Electronics and Electrical Communications Engineering, Tanta University, Tanta, Egypt. 5. Department of Electrical Engineering and Computer Science, Research Laboratory of Electronics, Massachusetts Institute of Technology, Cambridge, Massachusetts, USA. 6. Department of Ophthalmology, Faculty of Medicine, Cairo University, Cairo, Egypt.
Abstract
BACKGROUND: To evaluate the changes in the mean macular intercapillary area (ICA) from sequential enface optical coherence tomography angiography (OCTA) images following intravitreal anti-VEGF therapy in initially treatment-naïve eyes with diabetic macular oedema (DME). METHODS: In this multicenter retrospective study, 6x6 and 3x3 mm customized, total retinal projection enface OCTA images were collected and processed for quantitative assessment of ICA by a customized MATLAB software. Measurements were done in concentric regions centered on the fovea -with the exclusion of foveal avascular zone (FAZ)- in 0.5 mm diameter increments as well as within the intervening rings. RESULTS: 6x6 mm OCTA images from 46 eyes of 29 patients, and 3x3 mm OCTA images from 23 eyes of 15 patients were included in this study. There was no significant change in mean ICA after treatment in either scan size or in any measurement regions (all p > 0.05). Multivariate analysis revealed that baseline BCVA was significantly correlated with the visual outcome (p = 0.039). Additionally, after correction for age, baseline central retinal thickness (CRT), baseline BCVA, and retinopathy severity, mean ICA in the 1.5 mm circle was found to be a significant predictor of post treatment CRT, (p = 0.006). CONCLUSIONS: Absence of significant change in mean ICA after a minimum of three intravitreal anti-VEGF injections, may indicate that, in the short term, anti-VEGF injections neither impair nor improve macular perfusion in DME. Baseline BCVA was found to be a robust predictor of functional outcome, while inner mean ICA was a significant predictor for macular thickness outcomes. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.
BACKGROUND: To evaluate the changes in the mean macular intercapillary area (ICA) from sequential enface optical coherence tomography angiography (OCTA) images following intravitreal anti-VEGF therapy in initially treatment-naïve eyes with diabetic macular oedema (DME). METHODS: In this multicenter retrospective study, 6x6 and 3x3 mm customized, total retinal projection enface OCTA images were collected and processed for quantitative assessment of ICA by a customized MATLAB software. Measurements were done in concentric regions centered on the fovea -with the exclusion of foveal avascular zone (FAZ)- in 0.5 mm diameter increments as well as within the intervening rings. RESULTS: 6x6 mm OCTA images from 46 eyes of 29 patients, and 3x3 mm OCTA images from 23 eyes of 15 patients were included in this study. There was no significant change in mean ICA after treatment in either scan size or in any measurement regions (all p > 0.05). Multivariate analysis revealed that baseline BCVA was significantly correlated with the visual outcome (p = 0.039). Additionally, after correction for age, baseline central retinal thickness (CRT), baseline BCVA, and retinopathy severity, mean ICA in the 1.5 mm circle was found to be a significant predictor of post treatment CRT, (p = 0.006). CONCLUSIONS: Absence of significant change in mean ICA after a minimum of three intravitreal anti-VEGF injections, may indicate that, in the short term, anti-VEGF injections neither impair nor improve macular perfusion in DME. Baseline BCVA was found to be a robust predictor of functional outcome, while inner mean ICA was a significant predictor for macular thickness outcomes. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.
Authors: Ayman G Elnahry; Alia M Noureldine; Ahmed A Abdel-Kader; Osama A Sorour; David J Ramsey Journal: Diabetes Metab Syndr Obes Date: 2022-02-09 Impact factor: 3.168