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. 2023 May 13;13(10):1735.
doi: 10.3390/diagnostics13101735.

Preliminary Report on Optical Coherence Tomography Angiography Biomarkers in Non-Responders and Responders to Intravitreal Anti-VEGF Injection for Diabetic Macular Oedema

Sanjana Chouhan  1 , Rekha Priya Kalluri Bharat  1 , Janani Surya  1 , Sashwanthi Mohan  1 , Janarthanam Jothi Balaji  2 , V K Viekash  3 , Vasudevan Lakshminarayanan  4 , Rajiv Raman  1
Affiliations

Preliminary Report on Optical Coherence Tomography Angiography Biomarkers in Non-Responders and Responders to Intravitreal Anti-VEGF Injection for Diabetic Macular Oedema

Sanjana Chouhan et al. Diagnostics (Basel). .

Abstract

Purpose: To identify optical coherence tomography angiography (OCTA) biomarkers in patients who were treated for diabetic macular oedema (DME) with intravitreal anti-vascular endothelial growth factor (VEGF) injections and compare the OCTA parameters between responders and non-responders.

Methods: A retrospective cohort study of 61 eyes with DME who received at least one intravitreal anti-VEGF injection was included between July 2017 and October 2020. The subjects underwent a comprehensive eye examination followed by an OCTA examination before and after intravitreal anti-VEGF injection. Demographic data, visual acuity, and OCTA parameters were documented, and further analysis was performed pre- and post-intravitreal anti-VEGF injection.

Results: Out of 61 eyes which underwent intravitreal anti-VEGF injection for diabetic macular oedema, 30 were responders (group 1) and 31 were non-responders (group 2). We found that the responders (group 1) had a higher vessel density in the outer ring that was statistically significant (p = 0.022), and higher perfusion density was noted in the outer ring (p = 0.012) and full ring (p = 0.044) at levels of the superficial capillary plexus (SCP). We also observed a lower vessel diameter index in the deep capillary plexus (DCP) in responders when compared to non-responders (p < 0.00).

Conclusion: The evaluation of SCP in OCTA in addition to DCP can result in a better prediction of treatment response and early management in diabetic macular oedema.

Keywords: anti-vascular endothelial growth factor (VEGF) injection; biomarkers; diabetic macular oedema (DME); optical coherence tomography angiography (OCTA).

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Graph showing the percentage change in CST pre- and post-intravitreal anti-VEGF injection divided into 4 quartiles. Quartiles 1 and 2 were classified as group 1 (responder) and quartiles 3 and 4 were group 2 (non-responder). CST: central subfield thickness.
Figure 2
Figure 2
En-face image of the superficial retinal vasculature on OCTA overlaid with ETDRS grid. (1—Center, 2—Inner temporal, 3—Inner Superior, 4—Inner Nasal, 5—Inner inferior, 6—Outer temporal, 7—Outer superior, 8—Outer Nasal, 9—Outer inferior).
Figure 3
Figure 3
Methodology flow chart: Image processing: (1) Original non-marked image, (2) crop off the image description, (3) crop to the region of interest, (4) Prewitt edge detection, (5) image dilation, (6) image erosion and false positive removal, FAZ final output: (7a) infilled segmentation of detected FAZ region, (7b) outline segmentation of detected FAZ region.
See this image and copyright information in PMC

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