scholarly journals Hyperreflective Foci and Subretinal Fluid Are Potential Imaging Biomarkers to Evaluate Anti-VEGF Effect in Diabetic Macular Edema

2021 ◽  
Vol 12 ◽  
Author(s):  
Shiyue Qin ◽  
Chaoyang Zhang ◽  
Haifeng Qin ◽  
Hai Xie ◽  
Dawei Luo ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Pigment Epithelium ◽  
Retinal Pigment ◽  
Subretinal Fluid ◽  
Foveal Avascular Zone ◽  
Imaging Biomarkers ◽  
Hyperreflective Foci ◽  
Anti Vegf

Purpose: The aim was to investigate the effect and underlying mechanism of anti-vascular endothelial growth factor (anti-VEGF) in diabetic macular edema (DME) by optical coherence tomography angiography (OCTA).Methods: Twenty-five eyes in 18 treatment-naïve patients with DME were included. All eyes were imaged by OCTA at baseline and 1 week after monthly intravitreal aflibercept injection (IAI). Visual acuity was measured as best corrected visual acuity (BCVA). Additional parameters were evaluated by OCTA, including central macular thickness (CMT), the number of hyperreflective foci (HRF), foveal avascular zone (FAZ), vessel density (VD) in the deep capillary plexus (DCP), the en-face area of cystoid edema in DCP segmentation, and subretinal fluid (SRF) height.Results: The mean time between baseline and final follow-up by OCTA was 79.24 ± 38.15 (range, 28–163) days. Compared with baseline, BCVA was increased significantly after the 3rd IAI, while CMT was decreased significantly from the 1st IAI. SRF height and the area of cystoid edema in DCP segmentation were decreased significantly after the 2nd IAI compared with baseline. The number of HRF was decreased significantly after the 1st IAI (8.87 ± 9.38) compared with baseline (11.22 ± 10.63). However, FAZ’s area and perimeter as well as VD in DCP showed no significant changes post-treatment.Conclusion: Anti-VEGF is effective in treating DME, improving visual acuity and decreasing macular edema. The decreased HRF indicates anti-inflammatory effects of aflibercept to deactivate retinal microglia/macrophages. The decreased cystoid edema and SRF height indicated improved drainage function of Müller glial cells and retinal pigment epithelium after IAI.

scholarly journals Relationship between Outer Retinal Layers Thickness and Visual Acuity in Diabetic Macular Edema

2015 ◽  
Vol 2015 ◽  
pp. 1-5 ◽  
Author(s):  
Raymond L. M. Wong ◽  
Jacky W. Y. Lee ◽  
Gordon S. K. Yau ◽  
Ian Y. H. Wong
Keyword(s):  
Visual Acuity ◽  
Macular Edema ◽  
Correlation Coefficient ◽  
Diabetic Macular Edema ◽  
Retinal Thickness ◽  
Pigment Epithelium ◽  
Retinal Pigment ◽  
Retinal Layers ◽  
Snellen Chart ◽  
Foveal Center

Purpose. To investigate the correlation of outer retinal layers (ORL) thickness and visual acuity (VA) in patients with diabetic macular edema (DME).Methods. Consecutive DME patients seen at the Retina Clinic of The University of Hong Kong were recruited for OCT assessment. The ORL thickness was defined as the distance between external limiting membrane (ELM) and retinal pigment epithelium (RPE) at the foveal center. The correlation between total retinal thickness, ORL thickness, and vision was calculated.Results. 78 patients with DME were recruited. The mean age was 58.1 years (±11.5 years) and their mean visual acuity measured with Snellen chart was 0.51 (±0.18). The correlation coefficient between total retinal thickness and visual acuity was 0.34 (P< 0.001) whereas the correlation coefficient was 0.65 between ORL thickness and visual acuity (P< 0.001).Conclusion. ORL thickness correlates better with vision than the total retinal thickness. It is a novel OCT parameter in the assessment of DME. Moreover, it could be a potential long term visual prognostic factor for patients with DME.

scholarly journals Significance of Hyperreflective Foci as an Optical Coherence Tomography Biomarker in Retinal Diseases: Characterization and Clinical Implications

2021 ◽  
Vol 2021 ◽  
pp. 1-10
Author(s):  
Serena Fragiotta ◽  
Solmaz Abdolrahimzadeh ◽  
Rosa Dolz-Marco ◽  
Yoichi Sakurada ◽  
Orly Gal-Or ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Pigment Epithelium ◽  
Retinal Pigment ◽  
Age Related Macular Degeneration ◽  
Retinal Diseases ◽  
Optical Coherence ◽  
Hyperreflective Foci ◽  
Age Related

Hyperreflective foci (HRF) is a term coined to depict hyperreflective dots or roundish lesions within retinal layers visualized through optical coherence tomography (OCT). Histopathological correlates of HRF are not univocal, spacing from migrating retinal pigment epithelium cells, lipid-laden macrophages, microglial cells, and extravasated proteinaceous or lipid material. Despite this, HRF can be considered OCT biomarkers for disease progression, treatment response, and prognosis in several retinal diseases, including diabetic macular edema, age-related macular degeneration (AMD), retinal vascular occlusions, and inherited retinal dystrophies. The structural features and topographic location of HRF guide the interpretation of their significance in different pathological conditions. The presence of HRF less than 30 μm with reflectivity comparable to the retinal nerve fiber layer in the absence of posterior shadowing in diabetic macular edema indicates an inflammatory phenotype with a better response to steroidal treatment. In AMD, HRF overlying drusen are associated with the development of macular neovascularization, while parafoveal drusen and HRF predispose to macular atrophy. Thus, HRF can be considered a key biomarker in several common retinal diseases. Their recognition and critical interpretation via multimodal imaging are vital to support clinical strategies and management.

scholarly journals Choroidal Vascularity Index as a Biomarker for Visual Response to Antivascular Endothelial Growth Factor Treatment in Diabetic Macular Edema

2021 ◽  
Vol 2021 ◽  
pp. 1-9
Author(s):  
Ningxin Dou ◽  
Shanshan Yu ◽  
Ching-Kit Tsui ◽  
Boyu Yang ◽  
Jianqiang Lin ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Growth Factor ◽  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Subretinal Fluid ◽  
Visual Response ◽  
Anti Vegf ◽  
Antivascular Endothelial Growth Factor ◽  
Endothelial Growth Factor ◽  
Growth Factor Treatment

Purpose. To investigate the choroidal vascularity index (CVI) as a prognostic factor for the visual efficacy of antivascular endothelial growth factor (VEGF) treatment in diabetic macular edema (DME). Methods. We retrospectively reviewed 92 DME eyes receiving anti-VEGF treatment, which were stratified as responders (≥5 letters gained) and nonresponders (<5 letters gained or lost). Baseline systematic features and optical coherence tomography features, including the CVI, adjusted ellipsoid zone (EZ) reflectivity, subretinal fluid (SRF), and disorganization of the retinal inner layers (DRIL), were evaluated between the two groups. Results. The baseline CVI was significantly lower in nonresponders than in responders ( 0.66 ± 0.05 , 0.69 ± 0.05 , and 0.72 ± 0.05 , p = 0.014 ). After adjusting for other factors, the baseline CVI, DRIL, SRF, and adjusted EZ reflectivity were significantly associated with visual outcomes (CVI: odds   ratio   OR = 0.17 , p = 0.006 ; adjusted EZ reflectivity: OR = 0.56 , p = 0.007 ; DRIL: OR = 6.71 , p = 0.001 ; and SRF: OR = 0.29 , p = 0.008 ). Conclusion. DME patients with a higher CVI, higher adjusted EZ reflectivity, the presence of SRF, and the absence of DRIL at baseline were more likely to gain >5 letters in visual acuity after anti-VEGF treatment. CVI may serve as a novel biomarker for visual response to anti-VEGF treatment in DME.

Change in Visual Acuity in Relation to Central Macular Thickness after Intravitreal Bevacizumab in Diabetic Macular Edema

2020 ◽  
Vol 36 (3) ◽  
Author(s):  
Muhammad Ali Haider ◽  
Uzma Sattar ◽  
Syeda Rushda Zaidi
Keyword(s):  
Visual Acuity ◽  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Intravitreal Bevacizumab ◽  
Macular Thickness ◽  
Rank Test ◽  
P Value ◽  
Central Macular Thickness ◽  
Anti Vegf ◽  
Quasi Experimental

Purpose: To evaluate the change in visual acuity in relation to decrease in central macular thickness,after a single dose of intravitreal Bevacizumab injection.Study Design: Quasi experimental study.Place and Duration of Study: Punjab Rangers Teaching Hospital, Lahore, from January 2019 to June 2019.Material and Methods: 70 eyes with diabetic macular edema were included in the study. Patients having high refractive errors (spherical equivalent of > ± 7.5D) and visual acuity worse than +1.2 or better than +0.2 on log MAR were excluded. Central macular edema was measured in μm on OCT and visual acuity was documentedusing Log MAR chart. These values were documented before and at 01 month after injection with intravitrealBevacizumab. Wilcoxon Signed rank test was used to evaluate the difference in VA beforeand after the anti-VEGF injection. Difference in visual acuity and macular edema (central) was observed,analyzed and represented in p value. P value was considered statistically significant if it was less than 0.01%.Results: Mean age of patients was 52.61 ± 1.3. Vision improved from 0.90 ± 0.02 to 0.84 ± 0.02 on log MARchart. The change was statistically significant with p value < 0.001. Central macular thickness reduced from 328 ±14 to 283 ± 10.6 μm on OCT after intravitreal anti-VEGF, with significant p value < 0.001.Conclusion: A 45 μm reduction in central macular thickness was associated with 0.1 Log MAR unit improvementin visual acuity after intravitreal Bevacizumab in diabetic macular edema.

scholarly journals Pharmacological Management of Diabetic Macular Edema in Real-Life Observational Studies

2018 ◽  
Vol 2018 ◽  
pp. 1-16 ◽  
Author(s):  
Laurent Kodjikian ◽  
David Bellocq ◽  
Thibaud Mathis
Keyword(s):  
Visual Acuity ◽  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Observational Studies ◽  
Real Life ◽  
Pharmacological Management ◽  
Anti Vegf ◽  
Pubmed Database ◽  
Baseline Visual Acuity

Objectives of the Study. Summary of observational studies concerning the pharmacological management of diabetic macular edema (DME). Methods. A literature review was conducted using the PubMed database on 1 February 2018 to identify studies evaluating the efficacy of anti-VEGF and dexamethasone (DEX) implants for DME. Studies with more than 10 patients and follow-up of more than 6 months were selected. Analyses were carried out on the overall population and on subgroups defined according to baseline visual acuity (BVA) and the patients’ naïve or non-naïve status. Results. Thirty-two studies evaluating the efficacy of anti-VEGF and 31 studies evaluating the efficacy of DEX-implants were retained, concerning 6,842 and 1,703 eyes, respectively. A mean gain of +4.7 letters for a mean of 5.8 injections (mean follow-up: 15.6 months) and +9.6 letters for a mean of 1.6 injections (10.3 months) was found in the anti-VEGF and DEX-implant studies, respectively. Final VA appears to be similar for both treatment (62 letters for anti-VEGF, 61.2 letters for DEX-implant), and BVA appears lower for DEX-implant, which may partially explain the greater visual gain. The DEX-implant studies show greater gains in VA compared to the anti-VEGF studies, especially for higher BVA. Indeed, mean gains for the subgroups of patients with BVA<50 letters, 50<BVA<60 letters, and BVA>60 letters are +4.3, +5.8, and +3.1 letters, respectively, in the anti-VEGF studies and +10.5, +9.3, and +8.8 letters, respectively, in the DEX-implant studies. Regarding the patient’s initial status, only naïve status appears to confer the best functional response in DEX-implant studies. Conclusion. Observational studies investigating DEX-implant report clinically similar final VA when compared to anti-VEGF, but superior visual gains in real-life practice. This latter difference could be due to the better BVA, but also to the fact that less injections were administered in the anti-VEGF observational studies than in the interventional studies.

scholarly journals Hyperreflective foci on optical coherence tomography associate with treatment outcome for anti-VEGF in patients with diabetic macular edema

PLoS ONE ◽  
2018 ◽  
Vol 13 (10) ◽  
pp. e0206482 ◽  
Author(s):  
Vivian Schreur ◽  
Lebriz Altay ◽  
Freekje van Asten ◽  
Joannes M. M. Groenewoud ◽  
Sascha Fauser ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Treatment Outcome ◽  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Optical Coherence ◽  
Hyperreflective Foci ◽  
Anti Vegf

Correlation of hyperreflective foci, status of photoreceptor layer, and visual acuity in diabetic macular edema

2015 ◽  
Vol 93 ◽  
pp. n/a-n/a
Author(s):  
A. Chebil ◽  
M. Ben Abdallah ◽  
F. Kort ◽  
A. Hassairi ◽  
R. Maamouri ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Photoreceptor Layer ◽  
Hyperreflective Foci

scholarly journals Diagnosis and Monitoring of Choroidal Osteoma through Multimodal Imaging

2014 ◽  
Vol 2014 ◽  
pp. 1-4 ◽  
Author(s):  
Theodoros Empeslidis ◽  
Usman Imrani ◽  
Vasileios Konidaris ◽  
Fizza Mushtaq ◽  
Pandelis Fotiou ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Pigment Epithelium ◽  
Retinal Pigment ◽  
Subretinal Fluid ◽  
Interesting Case ◽  
Choroidal Neovascularisation ◽  
Optical Biopsy ◽  
Fundus Fluorescein Angiography ◽  
Choroidal Osteoma ◽  
History Of

A 16-year-old Caucasian female with a 6-month history of decreased visual acuity and metamorphopsia in the left eye is reported. The fundus of the left eye revealed a well defined lesion in the macula region. Diagnosis of choroidal osteoma was established using spectral domain optical coherence tomography (OCT), fundus fluorescein angiography (FFA), indocyanine green angiography (ICG), and B-scan ultrasonography. Subretinal fluid (SRF) and retinal pigment epithelium (RPE) detachment were noted in the absence of obvious classic choroidal neovascularisation (CNV). The patient was followed up for over 13 months without any treatment in the interim and the lesion was noted to have enlarged but visual acuity and SRF had remained stable. We report an interesting case where subretinal fluid was noted in the absence of evident choroidal neovascularisation and provide an example of the imaging modalities application in the era of “optical biopsy.”

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