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Foveal Eversion: A Possible Biomarker of Persistent Diabetic Macular Edema
Alessandro Arrigo1, Emanuela Aragona2, Luigi Capone2
1Department of Ophthalmology, Scientific Institute San Raffaele Hospital, University Vita-Salute, Milan, Italy. alessandro.arrigo@hotmail.com.
Introduction:
We aimed to evaluate the impact of foveal eversion on treatment response and persistent diabetic macular edema (DME).
Methods:
The study was designed as interventional and prospective. DME eyes were treated with ranibizumab and/or dexamethasone (DEX) implants, or with fluocinolone acetonide (FAc) implants. FAc-treated eyes were eventually retreated by additional ranibizumab injections. Main outcome measure was the relationship between foveal eversion and both clinical outcome and persistent DME.
Results:
Sixty-eight DME eyes (68 patients) treated by anti-VEGF/DEX and 50 FAc-treated eyes (50 patients) were recruited. The follow-up was 16 ± 3 months. The anti-VEGF/DEX group and FAc-treated group were statistically matched for age, sex, DME duration and previous number of injections (p > 0.05). Both groups experienced statistically significant improvements of both BCVA and central macular thickness (p < 0.01) at the end of the follow-up. Persistent DME was shown by 46% of anti-VEGF/DEX eyes and 42% of FAc-treated eyes. Foveal eversion was found in 50% of anti-VEGF/DEX eyes and in 44% of FAc-treated eyes. Its presence was associated with worse anatomical and visual outcome and higher persistence of DME in both groups (p < 0.01) and with higher retreatment percentages in FAc-treated eyes (p < 0.01).
Conclusion:
Foveal eversion is associated with worse clinical and morphological outcomes in DME.
