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Analysis of retinal layer thickness in diabetic macular oedema treated with ranibizumab or triamcinolone
Author(s) -
Prager Sonja G.,
Lammer Jan,
Mitsch Christoph,
Hafner Julia,
Pemp Berthold,
Scholda Christoph,
Kundi Michael,
SchmidtErfurth Ursula,
Kriechbaum Katharina
Publication year - 2018
Publication title -
acta ophthalmologica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.534
H-Index - 87
eISSN - 1755-3768
pISSN - 1755-375X
DOI - 10.1111/aos.13520
Subject(s) - triamcinolone acetonide , ranibizumab , ophthalmology , ganglion cell layer , retinal , medicine , nerve fiber layer , diabetic retinopathy , outer nuclear layer , retina , visual acuity , optical coherence tomography , diabetes mellitus , surgery , bevacizumab , biology , chemotherapy , neuroscience , endocrinology
Purpose To evaluate detailed changes in retinal layer thickness in spectral‐domain optical coherence tomography ( SD ‐ OCT ) images during a 1‐year follow‐up of patients treated for diabetic macula oedema ( DME ). Methods Post hoc analysis of retinal layer thickness changes applying the automated layer segmentation of SD ‐ OCT images in eyes with DME that were randomly assigned to receive pro re nata (PRN) treatment with either 0.5 mg ranibizumab or 8 mg triamcinolone. In each patient, seven retinal layers were segmented in 49 scans covering a 20° × 20° area of the macula at baseline and after 1 year of treatment. Changes in individual layer thickness were correlated with visual acuity (VA) and compared between treatment arms. Results Twenty‐five patients (seven female, 60.2 ± 15.1 years) were evaluated. Thickness decrease of retinal nerve fibre layer (RNFL) was associated with a gain in VA over 12 months ( r > 0.54; p < 0.05). Decrease in ganglion cell layer (GCL) and GCL + IPL thickness pooled for nasal Early Treatment of Diabetic Retinopathy Study (ETDRS) subfields correlated with VA as follows: ranibizumab r = 0.74 ( GCL ) and r = 0.63 ( GCL + IPL ); and triamcinolone r = 0.45 ( GCL ) and r = 0.46 ( GCL + IPL ). Conclusion In DME therapy, reduction in RNFL thickness may have a considerable impact on retinal function, unrelated to the type of pharmacological treatment. Precise morphologic quantification of neurosensory layers by SD OCT offers new insight into disease pathology and therapeutic targets.