Optical coherence tomography use for estimation of the efficacy of anti VEGF therapy in diabetic retinopathy and diabetic macular edema.

摘要

Objectives: To observe the role of optical coherence tomography in patientsreceiving anti-vascular endothelial growth factors for the treatment of diabetic retinopathy. StudyDesign: Observational descriptive study. Setting: The study was conducted at Department ofOphthalmology, Shahida Islam Teaching Hospital, Lodhran. Period: January 2018 to December2018. Material & Methods: 177 eyes of 156 patients with diabetic retinopathy were analyzedwith optical coherence tomography to quantify and explore changes in macula and inner retinalstructures and to see different patterns of DME pre and post intra-vitreal anti-VEGF injections.All eyes had baseline OCT, received anti-VEGF intra-vitreal injection Avastin (Bevacizumab)1.25mg/0.05ml. Follow up OCT imagining was done 6 weeks after last injection. Results: Thepatients had mean age of 58.36 ± 3.67 years with the mean diabetes duration of 9.30 ± 2.76years. Before intra-vitreal injection, two different patterns of DME were recognized and analyzedi.e. diffuse thickening of macula (n=117, 66.10%) and cystoids macular edema (n=60,33.90%). Base line OCT showed mean ± SD central foveal thickness 416 ± 54μm (n=177).On post intra-vitreal injection OCT, mean ± SD macular thickness was 212 ± 35 μm (n=177).Conclusion: OCT is latest non-invasive imaging modality that currently helps in quantifying andunderstanding the anatomy of DME and inner retinal damage due to diabetes mellitus. Althoughvascular leakage in DME is assessed qualitatively with Fluorescein angiography, actual macularthickness calculated with OCT is very helpful in yielding efficacy of treatment. This tool shouldalways be used in monitoring the effect of therapies in future studies.