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Published on: January 25, 2019
Peripapillary OCTA metrics in diabetic retinopathy patients with varying bevacizumab exposure: A cross-sectional
Farideh Mousavi1, Salar Nikmanesh1, Amin Arasteh2
1Department of Ophthalmology, Nikookari Eye Hospital, Tabriz University of Medical Sciences, Tabriz, Iran.
Objective:
To compare optic nerve head (ONH) microvasculature and retinal nerve fiber layer (RNFL) thickness of diabetic retinopathy (DR) patients with varying numbers of intravitreal bevacizumab (IVB) injections to non-diabetic controls via optical coherence tomography angiography (OCTA).
Methods:
It is a cross-sectional study of 246 eyes of 145 patients in 4 groups: group A: healthy control subjects (53 eyes); group B: DR without any IVB treatment (103 eyes); group C: DR one week after their first IVB injection (42 eyes); and group D: DR which received at least 9 IVB injections for the past year (48 eyes). All the included eyes underwent ONH OCTA using the AngioVue system, and the peripapillary vessel density (VD) and RNFL thickness were evaluated.
Results:
60 males and 85 females with a median age of 64.0 years were included in the study. The groups were not different in terms of age or sex. Groups C and D presented significantly lower peripapillary VDs than the controls (49.6 % and 48.9 % vs. 53.0 %, respectively, p < 0.001). The peripapillary VD was lower in treatment-naïve DR cases than in controls, but this difference was not statistically significant (51.4 % vs. 53.0 %). The whole-image VD was lower in group B than in group A (47.8 % vs. 49.6 %, p = 0.007); however, when the comparison was limited to mild to moderate DRs, the difference was insignificant (p = 0.949). Although the peripapillary VD was lower in group D cases than in group B cases (48.9 % vs. 51.4 %, p = 0.020), the subgroup analysis of severe NPDR patients in groups B, C, and D revealed no significant differences among the three groups in terms of peripapillary VD. However, the nasal segment VD was significantly lower in IVB-treated cases than in treatment-naïve cases. In addition, among treatment-naïve cases, the PDR cases had lower nasal VD than the mild NPDR cases. The RNFL thickness was not significantly different among the four groups (p = 0.256).
Conclusion:
Diabetic retinopathy and anti-VEGF treatment could reduce the peripapillary VD, which seems to happen primarily in the nasal segment and becomes evident in more advanced stages of DR. However, the frequency of IVB injections might not affect the peripapillary microvasculature.
