Original ArticleWidefield OCT-Angiography and Fluorescein Angiography Assessments of Nonperfusion in Diabetic Retinopathy and Edema Treated with Anti–Vascular Endothelial Growth Factor
Section snippets
Methods
An observational case series was conducted in a tertiary ophthalmologic center in Lariboisière Hospital, Paris, France. Eyes with DME associated with severe nonproliferative DR (NPDR) or proliferative DR (PDR) initiating anti-VEGF therapy were consecutively included over a 6-month period (May to November 2017).
Results
Ten eyes of 9 diabetic patients were included. Mean age of patients was 61.9±9.1 years (range, 49–76), and 7 patients were male. Eight patients had type 2 diabetes, and the mean diabetes duration was 16.1±10.3 years (1–31). Mean glycated hemoglobin A1 was 8.6±1.2% (6.8–10), and 8 patients received systemic therapy for high blood pressure. On the basis of the DRSS, 7 eyes were classified as severe NPDR, and 3 eyes were classified as PDR. Eight eyes were phakic at baseline. Eight eyes were
Discussion
In this study, we investigated whether retinal capillary perfusion changed after 3 anti-VEGF injections in eyes with severe NPDR or PDR, using SS-WF OCTA in addition to UWF FA. In none of the cases was the reperfusion of arterioles, venules, or capillaries observed in NP areas at M3, despite improvement of the DRSS based on CFP. The absence of reperfusion of retinal capillaries at M3 was unequivocal on OCTA. All NP areas detected on FA were also seen on SS-WF OCTA, but additional NP areas were
Acknowledgments
The authors thank Zeiss Inc., for providing the Wide-Field Swept-Source OCTA device (PlexElite OCTA, Carl Zeiss Meditec, Inc., Humphrey Division).
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Financial Disclosure(s): The author(s) have made the following disclosure(s): A.C.: Personal fees – Allergan, Bayer, Novartis, outside of the submitted work.
P.-A.R.: Personal fees – Allergan, Bausch and Lomb, Zeiss, outside of the submitted work.
A.E.: Grants – Allergan, Bayer, Novartis, outside of the submitted work.
S.B.: Personal fees – Bayer HealthCare, outside of the submitted work.
B.D.: Personal fees – Bayer, Novartis, outside of the submitted work.
A.G.: Personal fees – Novartis, Bayer HealthCare, Thrombogenics, outside of the submitted work.
R.T.: Personal fees – Novartis, Bayer, Roche, Genentech, Allergan, Zeiss, Alcon, Oculias, outside of the submitted work. All authors attest that they meet the current International Committee of Medical Journal Editors’ criteria for authorship.
The Department of Ophthalmology of Lariboisière Hospital received an independent research grant from Novartis Pharma SAS. The funding organization had no role in the design or conduct of this research.
HUMAN SUBJECTS: Human subjects were included in this study. The human ethics committees at the Société Française d’Ophtalmologie approved the study. All research adhered to the tenets of the Declaration of Helsinki. All participants provided informed consent.
No animal subjects were used in this study.
Author Contributions:
Conception and design: Couturier, Gaudric, Tadayoni
Data collection: Couturier, Rey, Erginay, Lavia, Bonnin, Dupas, Gaudric, Tadayoni
Analysis and interpretation: Couturier, Rey, Erginay, Lavia, Bonnin, Dupas, Gaudric, Tadayoni
Obtained funding: Couturier, Rey, Erginay, Bonnin, Dupas, Gaudric, Tadayoni
Overall responsibility: Couturier, Rey, Erginay, Lavia, Bonnin, Dupas, Gaudric, Tadayoni