Evaluation of the efficacy of anti-vascular endothelial growth factors in diabetic macular edema with retinal inner and outer layers disorganization

• Published in: Acta diabetologica Vol. 60; no. 10; pp. 1391 - 1398
• Main Authors: Kocapınar, Yıldırım, Kaplan, Fatih Bilgehan, Demirciler Sönmez, Ayşe, Açıkalın, Banu
• Format: Journal Article
• Language: English
• Published: Milan Springer Milan 01.10.2023; Springer Nature B.V
• Subjects: Bevacizumab; Diabetes; Diabetes mellitus; Diabetic retinopathy; Edema; Internal Medicine; Medicine; Medicine & Public Health; Metabolic Diseases; Original Article; Retina; Statistical analysis; Vascular endothelial growth factor; Diabetic retinopathy; Intravitreal injection; Disorganization of retinal inner and outer layers; Diabetic macular edema; Hyperreflective foci
• ISSN: 1432-5233; 0940-5429; 1432-5233
• DOI: 10.1007/s00592-023-02121-z

Aims This study aims to compare the effectiveness of treatment between anti-vascular endothelial growth factor (anti-VEGF) agents in diabetic macular edema (DME) patients with disorganization of retinal inner layers (DRIL). Epiretinal membrane, serous macular detachment, ellipsoid zone (EZ) disorder, external limiting membrane (ELM) disorder, and hyperreflective foci were also examined. Methods Patients treated for DME and also had DRIL were included in the study. The study design was retrospective and cross-sectional. The complete ophthalmologic records and imaging were scanned at the beginning, 3rd-month, 6th-month, and 12th-month follow-up, and the treatments administered were recorded. Anti-VEGF agents administered to the patients were examined in three groups: bevacizumab, ranibizumab, and aflibercept. Result A total of 141 eyes of 100 patients were included in our study. One hundred and fifteen eyes (81.6%) had a BCVA of 0, 5, or less at the beginning. There was no statistically significant difference between the three groups regarding initial BCVA and CMT and the change in BCVA and CMT at the beginning and the 12th month ( p  > 0.05). There was a negative correlation between EZ and ELM disorders in patients and the change in BCVA at 12 months ( r : 0.45 p  < 0.001, r : 0.32 p  < 0.001, respectively). The number of injections over five was positively correlated with the change in CMT but not with BCVA ( r : − 2.35 p  = 0.005 and r : 0.147 p  = 0.082, respectively). Conclusions No statistically significant difference was found between anti-VEGF agents when treating DME patients with DRIL. In addition, we have shown that anatomically better results were obtained in those who had five or more injections, although not in terms of BCVA.