DOES BASELINE SUB-FOVEAL CHORIODAL THICKNESS DETERMINES TREATMENT RESPONSE TO INTRAVITREAL AFLIBERCEPT IN DIABETIC MACULAR EDEMA?

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Published Feb 27, 2024
DOI: https://doi.org/10.35479/ijretina.2024.vol007.iss001.260

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Somesh Ranjan
Associate Professor, Department of Ophthalmology, Santosh medical College, Ghaziabad, India.
Harshraj Nehra
Associate Professor, Maharishi Markandeshwar Institute of Medical Sciences and Research, Mullana, Ambala, Haryana, India.
Vinod Sharma
Associate Professor, Department of Ophthalmology, Indira Gandhi, Medical College, Shimla, HP, India.
Kashish Goel
Resident, Department of Ophthalmology, Santosh medical College, Ghaziabad, India.
Madhu Kumari
Resident, Department of Ophthalmology, Santosh medical College, Ghaziabad, India.
Sarita Agarwal
Professor, Department of Ophthalmology, Santosh medical College, Ghaziabad, India.
Neharika Sharma
Resident, Department of Ophthalmology, School of Medical Sciences & Research, Sharda University
Bhavya Mehta
Assistant Professor, Department of Ophthalmology, GS Medical College & Hospital, Pilkhuwa, UP, India.
Ram Lal Sharma
Professor, Department of Ophthalmology, GS Medical College & Hospital, Pilkhuwa, UP, India.
Rahul Bhargava
GS Medical College

Abstract

Introduction: To determine the predictive value of baseline SFCT for response to treatment with serial intravitreal aflibercept injections for diabetic macular edema (DME).


Methods: A prospective multi-center study was done. Eyes with DME (n=95) were treated with intravitreal aflibercept injections q4week for first 5 doses, followed by 2mgq8week, respectively. SFCT and central macular thickness (CMT) were measured with serial enhanced depth imaging optical coherence tomography scans done at baseline and after the last injection. A functional responder was one with >5 ETDRS letter gain in vision. An anatomical responder was one with SFCT reduction>25u.


Results: At 6 months, after the last IV injection of aflibercept, the mean SFCT decreased significantly (319±47 at baseline, 250±36 at 6 months, P<0.001). A significantly higher baseline SFCT was seen in functional responders as compared to non-responders (329±50 versus 303±36u, independent t-test, P=0.002). Likewise, anatomical responders has a significantly higher baseline SFCT as compared to non-responders (327±51 versus 305±33, P=0.002). Multiple logistic regression (after adjusting for confounders like age, gender, duration of diabetes, and glycemic control, respectively) revealed that higher SFCT had increased odds of having a better functional (odds ratio=1.40, P=0.050) and anatomical outcome (odds ratio=1.23, P=0.001), respectively. The mean vision gain in functional responders and non-responders was 11and 5 ETDRS letters, respectively (P<0.001). The mean vision gain in anatomic responders and non-responders was 10 and 6 ETDRS letters, respectively (P<0.001).


 Conclusion: SFCT at baseline predicts response to intravitreal aflibercept therapy in DME patients after adjusting for confounders. Eyes with a thicker baseline sub-foveal choroidal thickness had better anatomic and functional response at 9 months.

Keywords

Diabetic macular edema, aflibercept, sub-foveal choroidal thickness, ETDRS vision

Article Details

How to Cite
RANJAN, Somesh et al. DOES BASELINE SUB-FOVEAL CHORIODAL THICKNESS DETERMINES TREATMENT RESPONSE TO INTRAVITREAL AFLIBERCEPT IN DIABETIC MACULAR EDEMA?. International Journal of Retina, [S.l.], v. 7, n. 1, p. 48, feb. 2024. ISSN 2614-8536. Available at: <https://ijretina.com/index.php/ijretina/article/view/260>. Date accessed: 08 sep. 2024. doi: https://doi.org/10.35479/ijretina.2024.vol007.iss001.260.
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Vol 7 No 1 (2024): International Journal of Retina (IJRetina) - INAVRS
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Research Articles
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