Relationship Between The Effect Of Anti-VEGF And The Characteristics Of Macular Structure In Diabetic Macular Edema

Objective:The purpose of this study is to observe the relationship between the effect of anti-VEGF in different OCT types of DME and their characteristics of macular structure.Methods:We reviewed 35 eyes of 27 patients who were diagnosed with DME and who had treated with anti-VEGF according to the 3+prn for at least 3 times and at least 3 months between January 2018 and October 2019 at the second affiliated Hospital of Chongqing Medical University.OCT showed three patterns of macular structure in diabetic macular edema: CME group(11 eyes),DRT group(12 eyes)and SRD group(12 eyes).The following data were collected: baseline BCVA,baseline CRT,post-treatment BCVA,post-treatment CRT.At the same time,we measured the following biomarkers at baseline:the DRIL、the number of HF in retinal layers,the area of FAZ and the retinal vessel density at the SCP and DCP,so as to analyze the the effect of anti-VEGF and the influence of macular structure characteristics on therapeutic effect.All statistical analyses were carriedout by version 26.0 SPSS statistical software(SPSS,Inc.,Chicago,IL.USA).All the data was presented as mean±SD,the BCVA was converted to a logarithm of minimum angle of resolution(logMAR).According to whether the data followed a normal distribution,within-group comparisons used the t test or nonparametric rank sum test,statistical comparisons between groups were made using oneway ANOVA or Kruskal-Wallis test,correlation analysis choose Pearson or Spearman analysis.Categorical variables were analyzed using the Fishers exact tests as appropriate.Results: 1.The BCVA(logMAR)of the three groups were improved after anti-VEGF treatment,but there was no significant difference among the three groups(p>0.05).The BCVA(logMAR)of the eyes in CME showed a statistically improvement(p<0.05).2.During the1-month follow-up after treatment,the CRT were significantly decreased compared with baseline in all three groups(p<0.05),but there was no significant difference among the three groups(p>0.05).At the last followup,the CRT of DRT group showed a statistically decrease(p<0.0.5).The CRT of CME and SRD also decreased,but there was no statistical significance between before and after treatment(p>0.05),there was no significant difference among the three groups(p>0.05).There was no significant correlation between the change of BCVA(logMAR)and the change of CRT(p=0.578,p= 0.470,p=0.151,p > 0.05).3.The baseline characteristics of OCT with different types of DME before anti-VEGF treatment were analyzed.It was found that the HF of the inner layer of DRT group before treatment was significantly less than that of CME(p = 0.044)and SRD(p = 0.001),but there was no significant difference between CME and SRD(p=0.413).4.It was found that the retinal vessel density at the DCP of SRD group before treatment was significantly lower than that in CME(p=0.006)and DRT(p=0.001),but there was no significant difference between CME and DRT(p = 0.584).No serious adverse events occurred in all patients during the follow-up period.Conclusion: In patients with DRT type,the CRT decreased more significantly after anti-VEGF treatment,but there was no significant correlation between the decrease of CRT and the improvement of BCVA.The number of HF and the retinal vessel density at the DCP may have effects on the efficacy of anti-VEGF in patients.The classification of DME by OCT can predict the efficacy of anti-VEGF.The analysis of characteristics in OCT and OCTA before treatment is a good guide for patients’ drug selection.