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Effects of macular ischemia on the outcome of intravitreal bevacizumab therapy for diabetic macular edema

Authors
 EUN JEE CHUNG  ;  MI IN ROH  ;  OH WOONG KWON  ;  HYOUNG JUN KOH 
Citation
 RETINA-THE JOURNAL OF RETINAL AND VITREOUS DISEASES, Vol.28(7) : 957-963, 2008 
Journal Title
 RETINA-THE JOURNAL OF RETINAL AND VITREOUS DISEASES 
ISSN
 0275-004X 
Issue Date
2008
MeSH
Adult ; Aged ; Angiogenesis Inhibitors/therapeutic use* ; Antibodies, Monoclonal/therapeutic use* ; Antibodies, Monoclonal, Humanized ; Bevacizumab ; Diabetic Retinopathy/drug therapy* ; Diabetic Retinopathy/physiopathology ; Female ; Fluorescein Angiography ; Humans ; Injections ; Ischemia/physiopathology* ; Macula Lutea/blood supply* ; Macular Edema/drug therapy* ; Macular Edema/physiopathology ; Male ; Middle Aged ; Retrospective Studies ; Tomography, Optical Coherence ; Treatment Outcome ; Vascular Endothelial Growth Factor A/antagonists & inhibitors ; Visual Acuity/physiology ; Vitreous Body
Keywords
diabetic macular edema ; intravitreal bevacizumab ; macular ischemia
Abstract
PURPOSE: To evaluate the effects of macular ischemia on visual outcomes in patients with diabetic macular edema (DME), after intravitreal bevacizumab injections. METHODS: Data on 59 eyes of 53 consecutive patients treated with intravitreal bevacizumab for DME were retrospectively reviewed. Data from preoperative fluorescein angiography (FA) tests were examined. Patients with an enlarged foveal avascular zone (FAZ), >or=1000 microm, or a broken perifoveal capillary ring at the border of the FAZ, with a distinct area of capillary nonperfusion within one disk diameter of the foveal center in the transit phase of fluorescein angiography, were defined as having macular ischemia. The patients were thus divided into two groups: with or without macular ischemia. Early Treatment Diabetic Retinopathy Study (ETDRS) scores, and foveal thicknesses measured using third generation ocular coherence tomography (OCT), were evaluated at baseline and at 1 month and 3 months after treatment. RESULTS: At 3 months after treatment, the mean visual acuity (VA) score decreased from a baseline VA of 0.52 +/- 0.27 (approximate Snellen equivalent, 20/63) to 0.57 +/- 0.21 (20/80) in the ischemic group. In the nonischemic group, by contrast, the VA improved from 0.66 +/- 0.34 (20/100) at baseline to 0.59 +/- 0.33 (20/80) at 3 months post-treatment. Nine of 18 eyes (50%) in the ischemic group, but only 9 of 41 eyes (21%) in the nonischemic group, experienced visual losses of >or=1 line on the ETDRS chart (P = 0.031, Pearson chi-square test). Four eyes (22%) in the ischemic group, but only 2 eyes (5%) in the nonischemic group, lost >or=3 lines (P = 0.042, Pearson chi-square test). CONCLUSION: Macular ischemia may have a negative effect on short term visual outcomes after intravitreal bevacizumab injections in patients with DME.
Full Text
http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&AN=00006982-200807000-00006&LSLINK=80&D=ovft
DOI
10.1097/IAE.0b013e3181754209
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Ophthalmology (안과학교실) > 1. Journal Papers
Yonsei Authors
Koh, Hyoung Jun(고형준) ORCID logo https://orcid.org/0000-0002-5932-8516
Kwon, Oh Woong(권오웅)
Roh, Mi In(노미인)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/107610
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