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Optical coherence tomography angiography for microaneurysms in anti-vascular endothelial growth factor treated

Tongmei Zhang1, Shiyong Xie1, Xiaoli Sun1

  • 1Tianjin Eye Hospital, Tianjin Key Lab of Ophthalmology and Visual Science, 4th Gansu Road, Heping District, Tianjin, 30020, PR China.

BMC Ophthalmology
|September 9, 2024
PubMed
Abstract

Insights

Microaneurysms (MAs) in diabetic macular edema (DME) patients treated with anti-vascular endothelial growth factor (anti-VEGF) therapy were larger and had more blood flow than in non-DME patients. MA size changes preceded central macular thickness improvements after treatment.

Area of Science:

  • Ophthalmology
  • Retinal Diseases
  • Diabetic Retinopathy

Background:

  • Diabetic retinopathy (DR) is a leading cause of vision loss.
  • Microaneurysms (MAs) are early signs of DR.
  • Understanding MA behavior after anti-vascular endothelial growth factor (anti-VEGF) therapy is crucial for managing chronic edema and treatment resistance.

Purpose of the Study:

  • To evaluate microaneurysms (MAs) in patients with diabetic retinopathy after anti-VEGF therapy.
  • To investigate the relationship between MA characteristics and diabetic macular edema (DME).
  • To explore factors contributing to chronic edema and resistance to anti-VEGF treatment.

Main Methods:

  • Optical coherence tomography angiography (OCTA) was used to assess MAs in 48 eyes from 43 patients with non-proliferative diabetic retinopathy.
  • Key OCTA parameters included MA maximum diameter, material presence, flow signal, central macular thickness (CMT), foveal avascular zone, and capillary plexus measurements.
  • Patients were categorized into diabetic macular edema (DME) and non-DME (NDME) groups.

Main Results:

  • The DME group exhibited significantly larger MAs (mean diameter 99.40 μm) compared to the NDME group (mean diameter 74.70 μm) at baseline (P < 0.001).
  • A higher proportion of MAs showed measurable blood flow in the DME group (83.6%) versus the NDME group (59.3%) (P < 0.001).
  • Central macular thickness (CMT) differed significantly between DME and NDME groups throughout the 6-month follow-up (P < 0.001).

Conclusions:

  • Diabetic macular edema (DME) is associated with larger microaneurysms (MAs) and increased blood flow signal compared to non-DME.
  • Changes in MA diameter were observed earlier than changes in central macular thickness (CMT) following anti-VEGF therapy.
  • These findings highlight the role of MAs in DME pathogenesis and treatment response.
Keywords:
Diabetic macular edemaMicroaneurysms (MAs)Non-proliferative diabetic retinopathyOCT angiographyVascular endothelial growth factor

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