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Year : 2020  |  Volume : 21  |  Issue : 2  |  Page : 122-126

Anatomical and functional significance of choroidal thickness changes after anti-vascular endothelial growth factors injection in diabetic macular edema

Ophthalmology Department, Faculty of Medicine, Cairo University, Cairo, Egypt

Correspondence Address:
MD Shaimaa A Arfeen
7308, 83 Street, Al Mokattam, Cairo 11571
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/DJO.DJO_57_19

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Purpose The aim of this study was to evaluate the choroidal thickness (CT) changes and its effect on the early functional and anatomic outcome in eyes with diabetic macular edema (DME) following intravitreal injection of bevacizumab by using enhanced depth imaging optical coherence tomography. Design This is a prospective interventional study. Patients and methods A total of 40 eyes (of 27 patients) with clinically significant DME were included in the present study. Evaluation of CT at different points before and after three intravitreal injections of bevacizumab was done by using enhanced depth imaging optical coherence tomography. Patients were classified according to the anatomic and functional outcome to responder and nonresponder groups. Results There was a significant decrease in the mean subfoveal CT from 425.47±96.61 to 374.75±99.71 μm following the three intravitreal injections (P<0.001). All examined quadrants of the choroid (nasal, temporal, superior, and inferior) showed significant decrease in thickness from 306.29±66.29, 313.85±65.01, 322.14±66.03, and 314.64± 62.93 μm, respectively, to 267.85±69.49, 273.00±71.76, 279.75±64.36, and 275.91±57.89 μm, respectively. There was a significant decrease in CT in the anatomic responder group (mean change was 49.68 μm compared with 21.43 μm in the nonresponder group; P=0.023), as well as in the functional responder group (mean change was 49.68 μm compared with 21.43 μm in the nonresponder group; P=0.023). Conclusion Over a 3-month period, the use of intravitreal bevacizumab was associated with significant thinning of the choroid in DME which did not correlate with visual acuity changes. The responder groups showed significant reduction in CT as compared with the nonresponder groups. CT changes following bevacizumab injection might represent secondary nonspecific changes with no definite predictive value on the outcome.

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