OCT Angiography Biomarkers for Predicting Visual Outcomes after Aflibercept Treatment for Diabetic Macular Edema

Author: Ahmed Arfaoui (Tunisia)

Co-authors: Rahma Saidane, Racem Choura, Asma Khallouli, Slim Selmi, Afef Maalej, Riadh Rannen

Purpose

To correlate OCT angiography (OCTA) parameters with clinical features and to predict the visual outcomes after Aflibercept treatment for diabetic macular edema (DME).

Setting/Venue

Department of Ophthalmology of the Military Hospital of Tunis, Tunisia.

Methods

Forty eyes of 40 patients with DME and 40 eyes of 40 age-matched healthy controls were enrolled in the study. All subjects underwent a comprehensive ocular examination, including measurement of best-corrected visual acuity (BCVA) and a slit-lamp exam of the anterior segment and fundus. Spectral Domain OCT and OCT-A scans were performed using AngioVue software of the Optovue RTVue XR Avanti. A 6 mm×6 macular scans with measurement of the foveal avascular zone (FAZ) and vessel densities (VD) in both superficial (SCP) and deep (DCP) capillary plexus were analyzed in both groups. The OCT-A scans were obtained at baseline and after 3 monthly injections of Aflibercept in the study group.

Results

The mean age was 62.7 ± 10.6 years in the study group and 61.9 ± 13.5 years in the control group (P = 0.80). Twenty four of 40 patients in the study group were women, and 22 of 40 subjects in the control group were women (P = 0.45). The FAZ in the study group at baseline was larger compared to the control group (P < 0.001). As for VDs, the values of both SCP and DCP in the study group at baseline all were lower than those in the control group (P < 0.001 for all). After treatment with Aflibercept, the FAZ area significantly decreased (P =0.032). Furthermore, the VDs also increased significantly (P < 0.05 for all). However, the values still did not return to the normal levels when compared with those of the control group. Among all biomarkers, higher SCP VDs at baseline correlated most significantly with visual gain after treatment (R=0.62, P < 0.001). No baseline OCTA biomarkers showed any significant correlation specifically with anatomic improvement.

Conlusions

Our findings suggest that for eyes with DME, VD SCP at baseline was an independent predictor for visual improvement after the loading Aflibercept treatment. However, further studies are warranted to confirm our results.

Financial Disclosure

The authors declare no conflict of interest.

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