Purpose

To analyze the morphological characteristics and long-term visual outcomes in eyes with diabetic retinopathy (DR) and diabetic macular edema (DME) treated with anti−vascular endothelial growth factor (anti-VEGF) therapy.

Design

Retrospective clinical cohort study.

Methods

Patients with a long-term follow-up and evidence of resolved DME in at least 1 visit (study visit) after 5 years of follow-up after the initiation of anti-VEGF therapy were included. At the study visit, structural optical coherence tomography (OCT) scans were reviewed for qualitative features reflecting a distress of the neuroretina or retinal pigment epithelium (RPE). A quantitative topographical assessment of the inner and outer retinal thicknesses was also provided.

Results

A total of 61 eyes (50 patients) were included and were divided into 2 subgroups according to visual acuity (VA) at the study visit, yielding a group of 24 eyes with a VA <20/40 (“poor/intermediate vision” group), and 37 eyes with a VA ≥20/40 (“good vision” group). The external limiting membrane (ELM) and RPE bands were more frequently disrupted or absent in the poor/intermediate vision group (P = .003 and P = .019). Similarly, disorganization of retinal inner layers was more prevalent in the poor/intermediate vision group (P = .013). The foveal and parafoveal outer retinal thicknesses were reduced in eyes with poor/intermediate vision (P = .022 and P = .044). Multivariate stepwise linear regression analysis demonstrated that VA was associated with appearances of the RPE and ELM (P < .0001 and P = .048), foveal and parafoveal outer retinal thicknesses (P = .046 and P = .035).

Conclusions

Modifications in the outer retina and RPE represent OCT biomarkers of long-term visual outcomes in eyes with DME treated with anti-VEGF.

中文翻译：

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用抗 VEGF 治疗治疗糖尿病性黄斑水肿的眼睛视力丧失的长期视觉结果和形态学生物标志物

目的

分析抗血管内皮生长因子 (anti-VEGF) 治疗治疗糖尿病视网膜病变 (DR) 和糖尿病黄斑水肿 (DME) 眼睛的形态学特征和长期视力结果。

设计

回顾性临床队列研究。

方法

包括在开始抗 VEGF 治疗后 5 年随访后至少 1 次访视（研究访视）有证据表明 DME 得到解决的长期随访患者。在研究访问中，对结构光学相干断层扫描 (OCT) 扫描进行了审查，以确定反映神经视网膜或视网膜色素上皮 (RPE) 窘迫的定性特征。还提供了内部和外部视网膜厚度的定量地形评估。

结果

共纳入 61 只眼（50 名患者），并根据研究访视时的视力 (VA) 分为 2 个亚组，产生一组 24 只眼，VA <20/40（“差/中等视力”组)，以及 37 只眼 VA ≥20/40（“良好视力”组）。在视力不佳/中等视力组中，外界膜 (ELM) 和 RPE 条带更频繁地被破坏或缺失（P  = .003 和P  = .019）。同样，视网膜内层的紊乱在视力不佳/中等视力组中更为普遍（P  = .013）。视力差/中等视力的眼睛中央凹和中央凹旁外层视网膜厚度减少（P  = .022 和P = .044)。多变量逐步线性回归分析表明，VA 与 RPE 和 ELM 的外观（P < .0001 和P  = .048）、中心凹和中心凹外层视网膜厚度（P  = .046 和P  = .035）相关。

结论

外层视网膜和 RPE 的改变代表了用抗 VEGF 治疗的 DME 眼睛中长期视觉结果的 OCT 生物标志物。