Qualitative OCT biomarkers for visual improvement in treatment of diabetic macular edema

Abstract

To identify baseline qualitatative OCT biomarkers that can predict good visual outcome in diabetic macular edema after treatment. Prospective, observational study in the time period. We included 37 eyes of 37 patients with treatment naïve diabetic macular edema who subsequently underwent treatment with injections of intravitreal Ranibizumab. Inclusion criteria was: Presenting vision < 0.3 logMaR (2) centre involving diabetic macular edema (CMT>250 microns). 3 injections were given monthly irrespective of treatment response followed by PRN dosing. Factors under evaluation were: 1) Submacular detachment (SMD) (2) cystoid changes in the inner and outer nuclear layer (4) Integrity of IS-OS junction. (5) Hyper Reflective Foci(HRF) and location (6) vitreomacular interface (7) Disruption of inner retinal layers(DRIL) We included 37 eyes in our study. For analysis, based on final visual acuity patients were divided in two groups: (1) Group A: Good visual acuity (>10 ETDRS letter gain) and (2) Group B: Poor visual outcome (< 10 letter gain). Presence of SMD was more likely in Group B as compared to Group A. There was no significant difference between two groups for other mentioned parameters. Presence of SMD was found to have most significance in predicting good visual acuity response to anti VEGF.DRIL was found to decrease during the treatment but a predictive role could not be demonstrated.