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. 2021 Jun 1;41(6):1283-1292.
doi: 10.1097/IAE.0000000000003029.

CHANGES IN SUBFOVEAL CHOROIDAL THICKNESS AFTER INTRAVITREAL DEXAMETHASONE IMPLANT THERAPY FOR DIABETIC MACULAR EDEMA

Ka Young Moon  1 , Shin Young Choi, Ji Hun Song
Affiliations

CHANGES IN SUBFOVEAL CHOROIDAL THICKNESS AFTER INTRAVITREAL DEXAMETHASONE IMPLANT THERAPY FOR DIABETIC MACULAR EDEMA

Ka Young Moon et al. Retina. .

Abstract

Purpose: To investigate changes in subfoveal choroidal thickness (SFCT) and their relationship with best-corrected visual acuity and optical coherence tomography parameters after intravitreal dexamethasone implant injection for diabetic macular edema.

Methods: Eighty-one eyes treated with dexamethasone implant injection for diabetic macular edema were evaluated for best-corrected visual acuity, central macular thickness, SFCT, and optical coherence tomography parameters at baseline and Weeks 7 and 14.

Results: The mean baseline SFCT significantly decreased at Weeks 7 (P < 0.001) and 14 (P < 0.001). At Week 7, each 1-µm reduction in central macular thickness and five Early Treatment Diabetic Retinopathy Study letters (-0.1 logarithm of the minimal angle of resolution) improvement were associated with SFCT reductions of 0.09 (P = 0.002) and 3.91 (P = 0.044) µm, respectively. At Week 14, each 1-µm reduction in central macular thickness was associated with a 0.14-µm reduction in SFCT (P < 0.001). Eyes with good functional and anatomical responses exhibited significantly greater SFCT reductions. Subretinal fluid resulted in greater SFCT changes (P = 0.039) and better best-corrected visual acuity (P = 0.033) at Week 7. A continuous ellipsoid zone/interdigitation zone layer was associated with a smaller mean SFCT at Week 7 (P = 0.002) and better best-corrected visual acuity at Weeks 7 and 14 (both, P < 0.001).

Conclusion: Changes in SFCT after dexamethasone implant injection therapy for diabetic macular edema may predict anatomical and functional outcomes and correlate with optical coherence tomography features that are known as predictors of treatment response.

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Conflict of interest statement

None of the authors has any conflicting interests to disclose.

Figures

Fig. 1.
Fig. 1.
Enhanced depth imaging OCT findings for a representative eye with DME treated with DEX injection. A. Baseline OCT images show cystoid DME with a giant outer nuclear layer cyst, small inner nuclear layer cysts, and a disrupted ellipsoid zone/interdigitation zone layer. B. Optical coherence tomography images at 7 weeks after DEX injection. C. Optical coherence tomography images at 14 weeks after DEX injection. The subfoveal choroidal thickness (double-headed arrow) was measured from the outer border of the hyperreflective line of the retinal pigment epithelium perpendicular to the chorioscleral interface (arrowheads) under the center of the fovea using the caliper program of the Heidelberg Eye Explorer software of OCT.
Fig. 2.
Fig. 2.
Changes in the mean central macular thickness (A), subfoveal choroidal thickness (B), and BCVA (C) at 7 and 14 weeks after dexamethasone implant injection, relative to baseline, in eyes with diabetic macular edema.
See this image and copyright information in PMC

Comment in

  • Correspondence.
    Gioia M, De Bernardo M, Capasso L, Rosa N. Gioia M, et al. Retina. 2021 Sep 1;41(9):e70. doi: 10.1097/IAE.0000000000003257. Retina. 2021. PMID: 34255762 No abstract available.
  • Reply.
    Song JH, Moon KY, Choi SY. Song JH, et al. Retina. 2021 Sep 1;41(9):e70-e71. doi: 10.1097/IAE.0000000000003258. Retina. 2021. PMID: 34432751 Free PMC article. No abstract available.

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