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Clinical effect of conbercept on improving diabetic macular ischemia by OCT angiography.

ABSTRACT: BACKGROUND:Varying degrees of macular ischemia generally occur in diabetic retinopathy (DR). This study aims to evaluate the effect of conbercept with 3+ pro re nata (PRN) on macular perfusion status in patients with diabetic macular edema (DME) and quantitatively assess changes in foveal avascular zone (FAZ) areas and capillary density in macular regions by applying optical coherence tomography angiography (OCTA). METHODS:Fifty patients were divided into ischemic (n =?31) and non-ischemic (n =?19) groups according to the presence of ischemia on OCTA at baseline. All patients received intravitreal injections of 0.5?mg of conbercept with 3+ PRN principle. The FAZ areas and macular vessel density measured using OCTA were evaluated at baseline, 3?months, and 6?months after treatment in both groups. RESULTS:At months 3 and 6, the FAZ area in the ischemic group changed from 0.510?±?0.171?mm2 to 0.441?±?0.158?mm2 then to 0.427?±?0.153?mm2 (p =?0.003, p =?0.296); in the non-ischemic group, it remained stable (p =?0.269, p =?0.926). The superficial vessel density changed from 41.1?±?4.1 to 42.5%?±?4.7% then to 42.6%?±?4.6% (p =?0.043, p =?0.812), and the deep vessel density changed from 40.7?±?4.4 to 42.3%?±?3.6% then to 42.3%?±?4.7% (p =?0.072, p =?0.961) in the ischemic group. In the non-ischemic group, the superficial vessel density changed from 44.8?±?3.2 to 46.0%?±?3.5% then to 45.7%?±?3.3% (p =?0.108, p =?0.666), whereas the deep vessel density changed from 43.6?±?3.6 to 43.8%?±?3.2% then to 43.5%?±?4.5% (p =?0.882, p =?0.736). Reperfusion in macular nonperfusion areas was observed. CONCLUSION:Anti-vascular endothelial growth factor treatment may have a positive effect on macular perfusion status. Furthermore, OCTA had advantages in quantifying and calculating blood flow index in the study of macular perfusion status.

SUBMITTER: Zhu Z

PROVIDER: S-EPMC7519504 | biostudies-literature | 2020 Sep

REPOSITORIES: biostudies-literature

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Clinical effect of conbercept on improving diabetic macular ischemia by OCT angiography.

Zhu Ziyi Z Liang Youling Y Yan Bin B Meng Zhishang Z Long Kejun K Zhang Yiwei Y Luo Jing J

BMC ophthalmology 20200925 1

<h4>Background</h4>Varying degrees of macular ischemia generally occur in diabetic retinopathy (DR). This study aims to evaluate the effect of conbercept with 3+ pro re nata (PRN) on macular perfusion status in patients with diabetic macular edema (DME) and quantitatively assess changes in foveal avascular zone (FAZ) areas and capillary density in macular regions by applying optical coherence tomography angiography (OCTA).<h4>Methods</h4>Fifty patients were divided into ischemic (n = 31) and non ...[more]

PMID: 32977791

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Project description:PurposeTo study longitudinal changes in retinal capillary circulation in eyes treated with iodine 125 (I125) plaque brachytherapy for uveal melanoma using OCT angiography (OCTA).DesignLongitudinal prospective study of 21 patients undergoing treatment for uveal melanoma with I125 plaque brachytherapy. Eyes with melanoma were imaged with OCTA before treatment and at 12-month intervals until 2 years after brachytherapy.ParticipantsAfter institutional review board approval, participants were enrolled prospectively from an academic ocular oncology clinic.MethodsPeripapillary (4.5 × 4.5-mm) and macular (3 × 3-mm) OCTA scans were acquired with AngioVue (Optovue, Inc, Fremont, CA).Main outcome measuresThe peripapillary nerve fiber layer plexus capillary density (NFLP_CD), macular superficial vascular complex vessel density (mSVC_VD), and foveal avascular zone (FAZ) area were calculated.ResultsBefore treatment, no significant difference was found in the NFLP_CD, mSVC_VD, or FAZ area between eyes with melanoma and normal fellow eyes. By 24 months, 11 eyes had developed clinical signs of radiation retinopathy, radiation optic neuropathy, or both. In treated eyes, the NFLP_CD (48.4±4.1%) was reduced at 12 months (46.7±5.0%; P = 0.04, Wilcoxon signed-rank test) and 24 months (44.5±6.1%; P < 0.001). Similarly, the mSVC_VD (48.4 2±3.6%) was reduced in treated eyes at 12 months (43.5±5.9%; P = 0.01) and 24 months (37.4±9.1%; P < 0.001). The FAZ area (0.26±0.11 mm2) increased in treated eyes at 12 months (0.35±0.22 mm2; P = 0.009) and 24 months (0.81±1.03 mm2; P = 0.001). When only eyes with clinically evident radiation changes were evaluated, the changes in NFLP_CD, mSVC_VD, and FAZ area were more pronounced. OCT angiography measurements correlated with both radiation dose and visual acuity. The mSVC_VD measured at 12 months was found to predict the development of clinically apparent radiation retinopathy within 1 year.ConclusionsOCT angiography demonstrated early emergence of peripapillary and macular capillary vasculature changes after I125 plaque brachytherapy. OCT angiography provided a quantitative measurement of retinal capillary changes associated with ischemia that correlated with visual acuity and radiation dose and may predict future development of radiation-induced retinal toxicity.

Project description:PurposeTo evaluate the diagnostic accuracy of machine learning (ML) techniques applied to radiomic features extracted from OCT and OCT angiography (OCTA) images for diabetes mellitus (DM), diabetic retinopathy (DR), and referable DR (R-DR) diagnosis.DesignCross-sectional analysis of a retinal image dataset from a previous prospective OCTA study (ClinicalTrials.govNCT03422965).ParticipantsPatients with type 1 DM and controls included in the progenitor study.MethodsRadiomic features were extracted from fundus retinographies, OCT, and OCTA images in each study eye. Logistic regression, linear discriminant analysis, support vector classifier (SVC)-linear, SVC-radial basis function, and random forest models were created to evaluate their diagnostic accuracy for DM, DR, and R-DR diagnosis in all image types.Main outcome measuresArea under the receiver operating characteristic curve (AUC) mean and standard deviation for each ML model and each individual and combined image types.ResultsA dataset of 726 eyes (439 individuals) were included. For DM diagnosis, the greatest AUC was observed for OCT (0.82, 0.03). For DR detection, the greatest AUC was observed for OCTA (0.77, 0.03), especially in the 3 × 3 mm superficial capillary plexus OCTA scan (0.76, 0.04). For R-DR diagnosis, the greatest AUC was observed for OCTA (0.87, 0.12) and the deep capillary plexus OCTA scan (0.86, 0.08). The addition of clinical variables (age, sex, etc.) improved most models AUC for DM, DR and R-DR diagnosis. The performance of the models was similar in unilateral and bilateral eyes image datasets.ConclusionsRadiomics extracted from OCT and OCTA images allow identification of patients with DM, DR, and R-DR using standard ML classifiers. OCT was the best test for DM diagnosis, OCTA for DR and R-DR diagnosis and the addition of clinical variables improved most models. This pioneer study demonstrates that radiomics-based ML techniques applied to OCT and OCTA images may be an option for DR screening in patients with type 1 DM.Financial disclosuresProprietary or commercial disclosure may be found after the references.

Dataset Information

Clinical effect of conbercept on improving diabetic macular ischemia by OCT angiography.

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Clinical effect of conbercept on improving diabetic macular ischemia by OCT angiography.

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