Influence of Intravitreal Therapy on Choroidal Thickness in Patients with Diabetic Macular Edema

This study aimed to analyze the variation in subfoveal choroidal thickness (SFCT) and its relationship with the variation in central macular thickness (CME) in response to intravitreal therapy with an antiangiogenic (anti-VEGF) drug or corticosteroid in type 2 diabetic patients with diabetic macular edema (DME).

This retrospective study included 70 eyes of 35 patients: 26 eyes received 4-5 intravitreal injections of aflibercept, 26 eyes were treated with a single intravitreal implant injection of dexamethasone, and 18 eyes without DME did not receive intravitreal therapy. SPECTRALIS® optical coherence tomography (OCT) (Heidelberg Engineering, Heidelberg, Germany) was used to measure the SFCT and CME before and at the end of the follow-up period.

The mean reductions in CME were 18.8 +/- 14.7% (aflibercept) and 29.7 +/- 16.9% (dexamethasone). The mean reductions in SFCT were 13.8 +/- 13.1% (aflibercept) and 19.5 +/- 9.6% (dexamethasone). The lowering effects of both parameters were significantly greater in the group treated with the dexamethasone implant (p = 0.022 and p = 0.046 for CMT and SFCT, respectively). Both therapies significantly decreased both CME and SFCT, independent of factors such as age, sex, previous intravitreal therapy, antidiabetic treatment, and the time of diabetes progression. There were no changes in the mean values of CME and SFCT in the untreated eyes.

SFCT significantly decreased in response to intravitreal therapy with anti-VEGF or corticosteroids, irrespective of age, sex, previous intravitreal therapy, antidiabetic treatment, and the time of diabetes progression. There was a correlation between the changes in CME and SFCT after intravitreal therapy with aflibercept or dexamethasone implantation. SFCT was not a good predictor of the CME response but could be used to monitor the response to treatment. Local intravitreal therapy only affected the treated eye.