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. 2024 Nov;61(11):1385-1392.
doi: 10.1007/s00592-024-02290-5. Epub 2024 May 27.

Changes in vessel density patterns assessed with OCTA in patients with diabetic macular edema treated with anti-VEGF therapy

Juan Santamaría  1   2   3 , Estefanía Cobos  4 , Marc Biarnes  5   6 , Josep María Caminal  4 , Ramon Rodriguez-Leor  7 , Rahul Morwani  4 , Manel García-Mendieta  8 , Daniel Lorenzo  4 , Pere García-Bru  4 , Luis Arias  4
Affiliations

Changes in vessel density patterns assessed with OCTA in patients with diabetic macular edema treated with anti-VEGF therapy

Juan Santamaría et al. Acta Diabetol. 2024 Nov.

Abstract

Aims: To determine the presence of sectoral changes in vessel density (VD) patterns induced by vascular endothelial growth factor inhibitors (anti-VEGF) in patients with diabetic macular edema (DME) using optical coherence tomography angiography (OCTA).

Methods: Prospective, interventional study. A total of 43 patients (63 eyes) were initially enrolled in the study. We performed swept source (SS) OCT and sectorial OCTA measurement to determine parafoveal VD at baseline and after six months of anti-VEGF treatment. In the locations with statistically significant differences in VD between baseline and month 6, we performed univariate and multivariate analyses to determine which, if any, of the baseline variables were associated with the observed changes.

Results: A total of 34 patients (48 eyes) were included in the final analysis. Mean VD decreased from baseline to month 6 (from 45.2 (± 3.5) to 44.6 (± 3.2) % in the SCP and from 50 (± 3.3) to 49 (± 3.9) % in the DCP). The only significant changes in VD were observed in the nasal sector of the deep capillary plexus, with a decrease of 2.9% (p = 0.001). On univariate and multivariate analyses, the only variable significantly associated with changes in VD in the nasal sector after 6 months of treatment was baseline VD in the same sector.

Conclusions: Anti-VEGF therapy has a small impact on VD values over time. These variations observed after treatment seems to be related to changes over areas of vascular anomalies and displaced vessels adjacent to cystic areas, with no significant changes over ischemic areas. No correlation was observed between this trend and other clinical baseline features.

Keywords: Anti-VEGF inhibitors; Diabetic macular edema; Optical coherence tomography angiography; Vessel density.

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Conflict of interest statement

The author(s) received no financial support for the research, authorship, and/or publication of this article.

Figures

Fig. 1
Fig. 1
A Pre-treatment B-scan with the corresponding optic coherence tomography angiography (OCTA) vessel density (VD) map of the superficial (SCP) and deep capillary plexus (DCP). B Post-treatment B-scan with the corresponding optic OCTA VD map of the SCP and DCP. Note the reduction in the VD values mainly at the level of the DCP where the cystic changes were previously located, while little change is seen at the level of the SCP
See this image and copyright information in PMC

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