Imaging biomarkers in diabetic macular oedema: Predicting vision beyond retinal thickness. Download PDF Subjects Predictive markers Retinal diseases Intravitreal anti-vascular endothelial growth factor (anti-VEGF) therapy has modified the natural history of diabetic macular oedema, although the visual outcome of treatment remains difficult to anticipate in the individual patient [ 1, 2 ]. Prognostic information available at the initiation of therapy is largely derived from group-level estimates reported in pivotal trials, whereas the functional response varies considerably between eyes with comparable anatomical presentations.
Central subfield thickness (CSFT) accounts for only a modest proportion of this variability, and its dissociation from visual acuity has been documented since the early analyses of the Diabetic Retinopathy Clinical Research Network [ 3, 4 ]. The limitation is therefore not the availability of imaging, but that of image-derived variables with demonstrated prognostic value. In their manuscript, Alhelaly and colleagues address this gap through a post hoc analysis of 60 eyes from the KINGFISHER trial for which baseline spectral-domain optical coherence tomography (OCT) and OCT angiography (OCTA) data were available [ 5, 6 ].
In the latter study, mean visual acuity improved from 62.9 letters at baseline to 75.4 letters at week 52. Greater baseline CSFT was the only independent predictor of baseline visual acuity. Importantly, both baseline CSFT and a composite measure of superficial perfusion density and vessel length density were independently associated with visual acuity at week 52, whereas a greater baseline volume of hyperreflective foci was independently associated with less visual acuity gain.
Medical Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with qualified healthcare professionals for medical decisions and treatment options.
Discover more from ChuckysCarnage
Subscribe to get the latest posts sent to your email.
