Foveal thickness reduction after anti-vascular endothelial growth factor treatment in chronic diabetic macular edema

Gabriel Willmann, Antonio Brunno Nepomuceno, Katharina Messias, Leticia Barroso, Ingrid Scott, André Messias, Rodrigo Jorge

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

AIM: To report foveal thickness reduction in eyes with resolution of macular edema and recovery of a foveal depression after one-year of anti-vascular endothelial growth factor (anti-VEGF) therapy for center-involving diabetic macular edema (DME). METHODS: Foveal thickness was assessed with optical coherence tomography to determine the central subfield foveal thickness (CSFT) and macular volume in 42 eyes with DME (CSFT>275 μm). Evaluations also included measurement of best-corrected visual acuity (BCVA), and were performed at baseline, and upon foveal depression recovery achieved after 12 monthly intravitreal injections of either 1.5 mg/0.06 mL bevacizumab (n=21) or 0.5 mg/0.05 mL ranibizumab (n=21). Data was compared to 42 eyes of normally sighted, non-diabetic, healthy individuals with similar age, gender and race distributions. RESULTS: Mean baseline BCVA was 0.59±0.04 and 0.32± 0.03 logMAR (P<0.001) after treatment and resolution of DME, with all, but 3 eyes, showing BCVA improvement. Mean CSFT before treatment was 422.0±20.0 μm, and after treatment, decreased to 241.6±4.6 μm (P<0.001), which is significantly thinner than CSFT found in control subjects (272.0±3.4 μm; P<0.001). Moreover, in 33/42 DM eyes (79%), CSTF was thinner than the matched control eye. Macular volume showed comparable results, but with lower differences between groups (control: 8.5±0.4 mm3; DME: 8.2±1.0 mm3; P=0.0267). CONCLUSION: DME eyes show significantly lower foveal thickness than matched controls after DME resolution achieved with one-year anti-VEGF therapy. Further investigation into the reasonsfor this presumable retinal atrophy using fluorescein angiography and functional parameters as well as establishing possible predictors is warranted. This finding should be considered during the treatment of DME.

Original languageEnglish (US)
Pages (from-to)760-764
Number of pages5
JournalInternational Journal of Ophthalmology
Volume10
Issue number5
DOIs
StatePublished - May 18 2017

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Macular Edema
Vascular Endothelial Growth Factor A
Visual Acuity
Therapeutics
Depression
Intravitreal Injections
Fluorescein Angiography
Optical Coherence Tomography
Atrophy
Control Groups

All Science Journal Classification (ASJC) codes

  • Ophthalmology

Cite this

Willmann, Gabriel ; Nepomuceno, Antonio Brunno ; Messias, Katharina ; Barroso, Leticia ; Scott, Ingrid ; Messias, André ; Jorge, Rodrigo. / Foveal thickness reduction after anti-vascular endothelial growth factor treatment in chronic diabetic macular edema. In: International Journal of Ophthalmology. 2017 ; Vol. 10, No. 5. pp. 760-764.
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abstract = "AIM: To report foveal thickness reduction in eyes with resolution of macular edema and recovery of a foveal depression after one-year of anti-vascular endothelial growth factor (anti-VEGF) therapy for center-involving diabetic macular edema (DME). METHODS: Foveal thickness was assessed with optical coherence tomography to determine the central subfield foveal thickness (CSFT) and macular volume in 42 eyes with DME (CSFT>275 μm). Evaluations also included measurement of best-corrected visual acuity (BCVA), and were performed at baseline, and upon foveal depression recovery achieved after 12 monthly intravitreal injections of either 1.5 mg/0.06 mL bevacizumab (n=21) or 0.5 mg/0.05 mL ranibizumab (n=21). Data was compared to 42 eyes of normally sighted, non-diabetic, healthy individuals with similar age, gender and race distributions. RESULTS: Mean baseline BCVA was 0.59±0.04 and 0.32± 0.03 logMAR (P<0.001) after treatment and resolution of DME, with all, but 3 eyes, showing BCVA improvement. Mean CSFT before treatment was 422.0±20.0 μm, and after treatment, decreased to 241.6±4.6 μm (P<0.001), which is significantly thinner than CSFT found in control subjects (272.0±3.4 μm; P<0.001). Moreover, in 33/42 DM eyes (79{\%}), CSTF was thinner than the matched control eye. Macular volume showed comparable results, but with lower differences between groups (control: 8.5±0.4 mm3; DME: 8.2±1.0 mm3; P=0.0267). CONCLUSION: DME eyes show significantly lower foveal thickness than matched controls after DME resolution achieved with one-year anti-VEGF therapy. Further investigation into the reasonsfor this presumable retinal atrophy using fluorescein angiography and functional parameters as well as establishing possible predictors is warranted. This finding should be considered during the treatment of DME.",
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Foveal thickness reduction after anti-vascular endothelial growth factor treatment in chronic diabetic macular edema. / Willmann, Gabriel; Nepomuceno, Antonio Brunno; Messias, Katharina; Barroso, Leticia; Scott, Ingrid; Messias, André; Jorge, Rodrigo.

In: International Journal of Ophthalmology, Vol. 10, No. 5, 18.05.2017, p. 760-764.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Foveal thickness reduction after anti-vascular endothelial growth factor treatment in chronic diabetic macular edema

AU - Willmann, Gabriel

AU - Nepomuceno, Antonio Brunno

AU - Messias, Katharina

AU - Barroso, Leticia

AU - Scott, Ingrid

AU - Messias, André

AU - Jorge, Rodrigo

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N2 - AIM: To report foveal thickness reduction in eyes with resolution of macular edema and recovery of a foveal depression after one-year of anti-vascular endothelial growth factor (anti-VEGF) therapy for center-involving diabetic macular edema (DME). METHODS: Foveal thickness was assessed with optical coherence tomography to determine the central subfield foveal thickness (CSFT) and macular volume in 42 eyes with DME (CSFT>275 μm). Evaluations also included measurement of best-corrected visual acuity (BCVA), and were performed at baseline, and upon foveal depression recovery achieved after 12 monthly intravitreal injections of either 1.5 mg/0.06 mL bevacizumab (n=21) or 0.5 mg/0.05 mL ranibizumab (n=21). Data was compared to 42 eyes of normally sighted, non-diabetic, healthy individuals with similar age, gender and race distributions. RESULTS: Mean baseline BCVA was 0.59±0.04 and 0.32± 0.03 logMAR (P<0.001) after treatment and resolution of DME, with all, but 3 eyes, showing BCVA improvement. Mean CSFT before treatment was 422.0±20.0 μm, and after treatment, decreased to 241.6±4.6 μm (P<0.001), which is significantly thinner than CSFT found in control subjects (272.0±3.4 μm; P<0.001). Moreover, in 33/42 DM eyes (79%), CSTF was thinner than the matched control eye. Macular volume showed comparable results, but with lower differences between groups (control: 8.5±0.4 mm3; DME: 8.2±1.0 mm3; P=0.0267). CONCLUSION: DME eyes show significantly lower foveal thickness than matched controls after DME resolution achieved with one-year anti-VEGF therapy. Further investigation into the reasonsfor this presumable retinal atrophy using fluorescein angiography and functional parameters as well as establishing possible predictors is warranted. This finding should be considered during the treatment of DME.

AB - AIM: To report foveal thickness reduction in eyes with resolution of macular edema and recovery of a foveal depression after one-year of anti-vascular endothelial growth factor (anti-VEGF) therapy for center-involving diabetic macular edema (DME). METHODS: Foveal thickness was assessed with optical coherence tomography to determine the central subfield foveal thickness (CSFT) and macular volume in 42 eyes with DME (CSFT>275 μm). Evaluations also included measurement of best-corrected visual acuity (BCVA), and were performed at baseline, and upon foveal depression recovery achieved after 12 monthly intravitreal injections of either 1.5 mg/0.06 mL bevacizumab (n=21) or 0.5 mg/0.05 mL ranibizumab (n=21). Data was compared to 42 eyes of normally sighted, non-diabetic, healthy individuals with similar age, gender and race distributions. RESULTS: Mean baseline BCVA was 0.59±0.04 and 0.32± 0.03 logMAR (P<0.001) after treatment and resolution of DME, with all, but 3 eyes, showing BCVA improvement. Mean CSFT before treatment was 422.0±20.0 μm, and after treatment, decreased to 241.6±4.6 μm (P<0.001), which is significantly thinner than CSFT found in control subjects (272.0±3.4 μm; P<0.001). Moreover, in 33/42 DM eyes (79%), CSTF was thinner than the matched control eye. Macular volume showed comparable results, but with lower differences between groups (control: 8.5±0.4 mm3; DME: 8.2±1.0 mm3; P=0.0267). CONCLUSION: DME eyes show significantly lower foveal thickness than matched controls after DME resolution achieved with one-year anti-VEGF therapy. Further investigation into the reasonsfor this presumable retinal atrophy using fluorescein angiography and functional parameters as well as establishing possible predictors is warranted. This finding should be considered during the treatment of DME.

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