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

作     者：Gabriel Willmann Antonio Brunno Nepomuceno Katharina Messias Leticia Barroso Ingrid U.Scott André Messias Rodrigo Jorge 

作者机构：Centre for Ophthalmology University of Tübingen Eye Hospital Katharinen Hospital Department of Ophthalmology Ribeirao Preto School of Medicine University of Sao Paulo Departments of Ophthalmology and Public Health Sciences Penn State College of Medicine 

出 版 物：《International Journal of Ophthalmology(English edition)》 (国际眼科杂志（英文版）)

年 卷 期：2017年第10卷第5期

页      面：760-764页

核心收录：

学科分类：1002[医学-临床医学] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 100212[医学-眼科学] 10[医学] 

基　　金：Supported by Fundacao de Amparoà Pesquisa do Estado de Sao Paulo(FAPESP)and FAEPA(Fundacao Apoioao Ensino Pesquisa e Assistência,HCFMRP-USP),(No.2010/013368) the initial trial was registered at clinical trials.gov(No.NCT01487629) 

主　　题：diabetes macular edema bevacizumab ranibizumab optical coherence tomography central subfield foveal thickness diabetic retinopathy 

摘      要：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 ***：Mean baseline BCVA was 0.59±0.04 and 0.32± 0.03 log MAR（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 mm^3; DME：8.2±1.0 mm^3; 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.