Efficacy of Intravitreal Anti-vascular Endothelial Growth Factor or Steroid Injection in Diabetic Macular Edema According to Fluid Turbidity in Optical Coherence Tomography
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Purpose: To determine if short term effects of intravitreal anti-vascular endothelial growth factor or steroid injectionare correlated with fluid turbidity, as detected by spectral domain optical coherence tomography (SD-OCT)in diabetic macular edema (DME) patients. Methods: A total of 583 medical records were reviewed and 104 cases were enrolled. Sixty eyes received asingle intravitreal bevacizumab injection (IVB) on the first attack of DME and 44 eyes received triamcinoloneacetonide treatment (IVTA). Intraretinal fluid turbidity in DME patients was estimated with initialintravitreal SDOCTand analyzed with color histograms from a Photoshop program. Central macular thickness and visualacuity using a logarithm from the minimum angle of resolution chart, were assessed at the initial period and 2months after injections. Results: Visual acuity and central macular thickness improved after injections in both groups. In the IVB group,visual acuity and central macular thickness changed less as the intraretinal fluid became more turbid. In theIVTA group, visual acuity underwent less change while central macular thickness had a greater reduction (r =-0.675, p = 0.001) as the intraretinal fluid was more turbid. Conclusions: IVB and IVTA injections were effective in reducing central macular thickness and improving visualacuity in DME patients. Further, fluid turbidity, which was detected by SD-OCT may be one of the indexes thathighlight the influence of the steroid-dependent pathogenetic mechanism.
Abstract
Purpose: To determine if short term effects of intravitreal anti-vascular endothelial growth factor or steroid injectionare correlated with fluid turbidity, as detected by spectral domain optical coherence tomography (SD-OCT)in diabetic macular edema (DME) patients. Methods: A total of 583 medical records were reviewed and 104 cases were enrolled. Sixty eyes received asingle intravitreal bevacizumab injection (IVB) on the first attack of DME and 44 eyes received triamcinoloneacetonide treatment (IVTA). Intraretinal fluid turbidity in DME patients was estimated with initialintravitreal SDOCTand analyzed with color histograms from a Photoshop program. Central macular thickness and visualacuity using a logarithm from the minimum angle of resolution chart, were assessed at the initial period and 2months after injections. Results: Visual acuity and central macular thickness improved after injections in both groups. In the IVB group,visual acuity and central macular thickness changed less as the intraretinal fluid became more turbid. In theIVTA group, visual acuity underwent less change while central macular thickness had a greater reduction (r =-0.675, p = 0.001) as the intraretinal fluid was more turbid. Conclusions: IVB and IVTA injections were effective in reducing central macular thickness and improving visualacuity in DME patients. Further, fluid turbidity, which was detected by SD-OCT may be one of the indexes thathighlight the influence of the steroid-dependent pathogenetic mechanism.
참고문헌 (23)
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