OCTA changes following loading phase with intravitreal aflibercept for DME.

Area of Science:

• Ophthalmology
• Medical Imaging
• Retinal Diseases

Background:

• Diabetic macular edema (DME) is a leading cause of vision loss in diabetic patients.
• Intravitreal anti-vascular endothelial growth factor (anti-VEGF) therapy is a standard treatment for DME.
• Optical coherence tomography angiography (OCTA) allows non-invasive visualization of retinal vasculature.

Purpose of the Study:

• To quantify changes in OCTA parameters after anti-VEGF treatment for DME.
• To assess the association between baseline OCTA parameters and visual outcomes in DME patients.

Main Methods:

• Prospective cohort study of 29 patients with DME receiving aflibercept injections.
• OCTA imaging performed at baseline and 6 months to analyze foveal avascular zone (FAZ) and vessel density.
• Statistical analysis included Wilcoxon signed-rank test and multivariable regression.

Main Results:

• A significant decrease in superficial vascular plexus density was observed in central and inner Early Treatment of Diabetic Retinopathy Study (ETDRS) map regions, particularly in treatment responders.
• No significant association was found between pretreatment OCTA parameters and final visual acuity outcomes.

Conclusions:

• Intravitreal aflibercept treatment leads to reduced superficial vessel density in responders, potentially due to OCTA technology limitations.
• Pretreatment OCTA parameters are not reliable biomarkers for predicting visual outcomes in DME patients treated with anti-VEGF therapy.