Impact of long-term intravitrealanti-vascular endothelial growth factor on preexisting microstructural alterations in diabetic macular edema

• Verfasst von: Wirth, Magdalena A. [VerfasserIn]
• Verfasst von: Becker, Matthias D. [VerfasserIn]
• Titel: Impact of long-term intravitrealanti-vascular endothelial growth factor on preexisting microstructural alterations in diabetic macular edema
• Verf.angabe: Magdalena A. Wirth, Juliana Wons, Florentina J. Freiberg, Matthias D. Becker, Stephan Michels
• Jahr: 2018
• Umfang: 6 S.
• Fussnoten: Gesehen am 01.04.2020
• Titel Quelle: Enthalten in: Retina
• Ort Quelle: Philadelphia, Pa. [u.a.] : Lippincott, Williams & Wilkins, 1981
• Jahr Quelle: 2018
• Band/Heft Quelle: 38(2018), 9, Seite 1824-1829
• ISSN Quelle: 1539-2864
• DOI: doi:10.1097/IAE.0000000000001788
• Datenträger: Online-Ressource
• Sprache: eng
• K10plus-PPN: 1693702525

Abstract

Purpose: Evaluation of the influence of long-term intravitreal anti-vascular endothelial growth factor treatment on preexisting retinal microstructural alterations in patients with diabetic macular edema. Methods: Eyes with diabetic macular edema and a history of ≥ 20 intravitreal anti-vascular endothelial growth factor (aflibercept and/or ranibizumab) injections were included in this retrospective study. Primary outcome was the extent of disorganization of retinal inner layers, alterations at the outer plexiform layer/Henle fiber layer junction, disruption of external limiting membrane/ellipsoid zone, disruption of retinal pigment epithelium/Bruch complex, and retinal atrophy at baseline versus after ≥ 20 intravitreal injections as visualized by spectral-domain optical coherence tomography images. Results: Of 383 eyes screened, 37 eyes were included in the current study. With the exception of outer plexiform layer/Henle fiber layer junction restoration, no significant changes regarding microstructural alterations between baseline and end of study were encountered after long-term anti-vascular endothelial growth factor (disorganization of retinal inner layers P = 0.381, outer plexiform layer/Henle fiber layer junction P = 0.001, external limiting membrane/ellipsoid zone P = 0.524, retinal pigment epithelium/Bruch complex P = 0.122, retinal atrophy P = 0.317). Best-corrected visual acuity significantly increased over the course of the study, corresponding to central retinal thickness and intraretinal fluid reduction (all P < 0.0001). The extent of microstructural alterations was negatively correlated with best-corrected visual acuity (P < 0.05). Conclusion: Apart from outer plexiform layer/Henle fiber layer junction layer restoration, no effect on preexisting retinal alterations was encountered after long-term intravitreal injections. Thus, intravitreal ranibizumab or aflibercept did not have a major effect (neither positive nor negative) on microstructural alterations.