Mean macular intercapillary area in eyes with diabetic macular oedema after anti-VEGF therapy and its association with treatment response.

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To evaluate the changes in the mean macular intercapillary area (ICA) from sequential enface optical coherence tomography angiography (OCTA) images following intravitreal anti-VEGF therapy in initially treatment-naïve eyes with diabetic macular oedema (DME).In this multicenter retrospective study, 6×6 and 3×3 mm customized, total retinal projection enface OCTA images were collected and processed for quantitative assessment of ICA by a customized MATLAB software. Measurements were done in concentric regions centered on the fovea -with the exclusion of foveal avascular zone (FAZ)- in 0.5 mm diameter increments as well as within the intervening rings.6×6 mm OCTA images from 46 eyes of 29 patients, and 3×3 mm OCTA images from 23 eyes of 15 patients were included in this study. There was no significant change in mean ICA after treatment in either scan size or in any measurement regions (all p > 0.05). Multivariate analysis revealed that baseline BCVA was significantly correlated with the visual outcome (p = 0.039). Additionally, after correction for age, baseline central retinal thickness (CRT), baseline BCVA, and retinopathy severity, mean ICA in the 1.5 mm circle was found to be a significant predictor of post treatment CRT, (p = 0.006).Absence of significant change in mean ICA after a minimum of three intravitreal anti-VEGF injections, may indicate that, in the short term, anti-VEGF injections neither impair nor improve macular perfusion in DME. Baseline BCVA was found to be a robust predictor of functional outcome, while inner mean ICA was a significant predictor for macular thickness outcomes. This article is protected by copyright. All rights reserved.

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Authors: Osama A Sorour, Mohamed Elsheikh, Siyu Chen, Ayman G Elnahry, Caroline R Baumal, Varsha Pramil, Tamer I Abdelhalim, Elsayed Nassar, Eric M Moult, Andre J Witkin, Jay S Duker, Nadia K Waheed