The area and number of intraretinal cystoid spaces predict the visual outcome after ranibizumab monotherapy in diabetic macular Edema

Norihiro Nagai, Misa Suzuki, Atsuro Uchida, Toshihide Kurihara, Norimitsu Ban, Sakiko Minami, Hajime Shinoda, Kazuo Tsubota, Yoko Ozawa

Research output: Contribution to journalArticlepeer-review

1 Citation (Scopus)

Abstract

Visual outcomes in diabetic macular edema (DME) after anti-vascular endothelial growth factor therapy vary across individuals. We retrospectively reviewed the clinical records for 46 treatment-naive eyes of 46 patients with DME who underwent intravitreal ranibizumab (IVR) monotherapy with a pro re nata regimen for 12 months. Overall, mean best-corrected visual acuity (BCVA) improved. Multivariate analyses adjusted for age and baseline BCVA showed that the area ratio, compared with the retinal area, and the number of intraretinal cystoid spaces evaluated on OCT (optical coherence tomography) images at baseline positively correlated with LogMAR BCVA and the extents of ellipsoid zone and external limiting membrane disruption at 12 months, and negatively correlated with central retinal thickness at the time of edema resolution. Therefore, a high area ratio and large number of intraretinal cystoid spaces resulted in a disorganized outer retinal structure at 12 months, a thin and atrophic retina after edema resolution, and a worse visual outcome. The area ratio and number of intraretinal cystoid spaces on initial OCT images were predictors of the visual outcome after IVR therapy in DME irrespective of baseline age and BCVA. The factors were related to retinal neurodegenerative changes in DME and could help in obtaining proper informed consent before treatment.

Original languageEnglish
Article number1391
JournalJournal of Clinical Medicine
Volume9
Issue number5
DOIs
Publication statusPublished - 2020 May

Keywords

  • Biomarker
  • Diabetic macular edema
  • Intraretinal cystoid space
  • Optical coherence tomography
  • Predictive factor

ASJC Scopus subject areas

  • Medicine(all)

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