Optical Coherence Tomography Biomarkers as Potential Predictors for Visual Function and Response to Intravitreal...

Area of Science:

• Ophthalmology
• Medical Imaging
• Retinal Diseases

Background:

• Diabetic macular edema (DME) is a leading cause of vision loss in diabetic patients.
• Optical coherence tomography (OCT) is crucial for diagnosing and monitoring DME.
• Identifying prognostic biomarkers in DME is essential for personalized treatment.

Purpose of the Study:

• To synthesize optical coherence tomography (OCT) biomarkers in diabetic macular edema (DME).
• To investigate the association of these biomarkers with visual acuity (VA).
• To evaluate biomarker response to intravitreal antivascular endothelial growth factor (anti-VEGF) and corticosteroid therapy.

Main Methods:

• A comprehensive literature review was conducted.
• Analysis focused on OCT-derived biomarkers in DME patients.
• Associations with visual acuity and treatment response were examined.

Main Results:

• Common biomarkers include disorganization of the inner retinal layers (DRIL), epiretinal membrane (ERM), ellipsoid zone (EZ) integrity, and external limiting membrane (ELM) continuity.
• Absence of DRIL/ERM and preserved ELM/EZ continuity correlate with better visual acuity and treatment response.
• Lower choroidal vascularity index favors anti-VEGF response, while RPE degradation, increased CRT, and foveal eversion are linked to poor outcomes.

Conclusions:

• Certain biomarkers like DRIL, hyperreflective dots, and CRT respond better to corticosteroids than anti-VEGF agents.
• Absence of DRIL and preserved EZ/ELM indicate improved visual outcomes.
• Further research on specific biomarkers and integration of AI in OCT imaging is needed for personalized DME treatment.