Effect of anti-vascular endothelial growth factor therapy on choroidal thickness in diabetic macular edema

Glenn C Yiu, Varsha Manjunath, Stephanie J. Chiu, Sina Farsiu, Tamer H. Mahmoud

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Abstract

PURPOSE: To determine the effect of anti-vascular endothelial growth factor (VEGF) therapy on choroidal thickness in eyes with diabetic macular edema (DME). DESIGN: Aretrospective, cohort analysis of 59 eyes from 59 patients with DME without prior anti-VEGF therapy. METHODS: Choroidal thickness was measured using semiautomated segmentation of enhanced depth imaging optical coherence tomography images at 0.5-mm intervals from 2.5 mm nasal to 2.5 mm temporal to the fovea. Changes in choroidal thickness with and without anti- VEGF treatment over 6 months were compared. Bestcorrected visual acuity and central foveal thickness were analyzed to evaluate the association of choroidal thickness with functional and anatomic outcomes. RESULTS: Of the 59 eyes with DME, 26 eyes were observed without treatment, whereas 33 underwent intravitreal anti-VEGF therapy (mean number of injections, 2.73) over 6 months. In untreated eyes, there was no significant change in best-corrected visual acuity (P [ .098), central foveal thickness (P [ .472), or choroidal thickness at all measurements along the macula (P[ .057 at the fovea). In eyes treated with anti-VEGF injections, choroidal thickness decreased significantly at the fovea (246.6 to 224.8 mm; P < .001) and at 0.5 mm nasal (240.9 to 221.9 mm; P [ .002) and 0.5 mm temporal (249.3 to 224.8 mm; P [ .011) to the fovea. The decrease in subfoveal choroidal thickness after anti-VEGF treatment was not associated with the cumulative number of anti-VEGF injections (R2 [ 0.031; P [ .327) or to changes in best-corrected visual acuity (R2 [ 0.017; P [ .470) or central foveal thickness (R2 [ 0.040; P [ .263). CONCLUSIONS: Central choroidal thickness decreases after anti-VEGF therapy for DME after 6 months, but may not be associated with functional or anatomic outcomes in eyes with DME.

Original languageEnglish (US)
Pages (from-to)745-751.e2
JournalAmerican Journal of Ophthalmology
Volume158
Issue number4
DOIs
StatePublished - 2014
Externally publishedYes

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ASJC Scopus subject areas

  • Ophthalmology

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