PMID- 30918814
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20201001
IS  - 2222-3959 (Print)
IS  - 2227-4898 (Electronic)
IS  - 2222-3959 (Linking)
VI  - 12
IP  - 3
DP  - 2019
TI  - Evaluation of outer retinal tubulations in diabetic macular edema underwent 
      anti-VEGF treatment.
PG  - 442-450
LID - 10.18240/ijo.2019.03.15 [doi]
AB  - AIM: To investigate the incidence and subsequent changes of outer retinal 
      tubulations (ORTs) in diabetic macular edema (DME) underwent anti-vascular 
      endothelial growth factor (VEGF) therapy, and to assess the possibility of ORT as 
      a biomarker of DME severity or response to anti-VEGF therapy. METHODS: This 
      retrospective and descriptive study included a total of 228 patients (435 eyes) 
      with DME and treated with intravitreal anti-VEGF agents between March 2016 and 
      January 2018. Patients were divided into 2 groups according to the presence of 
      ORTs. High-resolution spectral-domain optical coherence tomography (SD-OCT) 
      images acquired by vertical and horizontal scans and over consecutive visits were 
      analyzed. The evolution of ORT over time, type of fluid and subfoveal 
      photoreceptor integrity on OCT imaging was also assessed. RESULTS: ORTs were 
      identified in 108 eyes of 435 eyes with an overall incidence rate of 24.83% at 
      baseline. ORTs were prone to locate adjacent to the lesions of exudation and/or 
      cystoid edema and possibly situated in outer nuclear layer (ONL), outer plexiform 
      layer (OPL) and/or inner nuclear layer (INL) in eyes with DME. The formation 
      process of ORT led to focal downward displacement of OPL and INL toward RPE near 
      the lesion. During the follow up, 45 eyes had steady ORTs and 63 eyes had dynamic 
      variants in ORTs, including disappearance, reappearance, collapse, diminution, 
      and enlargement. There were higher proportion of closed ORTs and fewer proportion 
      of forming ORTs in eyes with steady ORTs, which showed a statistically 
      significance when compared with eyes with variant ORTs (P=0.006, P=0.017, 
      respectively). The eyes without ORTs had significantly better final best 
      corrected visual acuity (BCVA) and more BCVA change than those eyes with ORTs in 
      DME patients after anti-VEGF therapy (P=0.023, P=0.009, respectively). The 
      disruption of subfoveal photoreceptor integrity in eyes with ORTs was more 
      serious than that in eyes without ORTs (P=0.013). The proportion of stable vision 
      in eyes with ORTs was significantly higher than that in eyes without ORTs, 
      showing statistical significance (P=0.016). ORTs were associated with worse 
      visual prognosis due to damage of the subfoveal photoreceptor integrity. 
      CONCLUSION: ORTs have a high incidence and changes over time in DME with 
      anti-VEGF treatment and may be located at various retinal layers. Persistent ORT 
      can be as a negative biomarker of outcome of DME.
FAU - Huang, Xiao-Li
AU  - Huang XL
AD  - Department of Ophthalmology, Wuhan School of Clinical Medicine, Southern Medical 
      University (Wuhan General Hospital of Guangzhou Military Region), Wuhan 430060, 
      Hubei Province, China.
FAU - Song, Yan-Ping
AU  - Song YP
AD  - Department of Ophthalmology, Wuhan School of Clinical Medicine, Southern Medical 
      University (Wuhan General Hospital of Guangzhou Military Region), Wuhan 430060, 
      Hubei Province, China.
FAU - Ding, Qin
AU  - Ding Q
AD  - Department of Ophthalmology, Wuhan School of Clinical Medicine, Southern Medical 
      University (Wuhan General Hospital of Guangzhou Military Region), Wuhan 430060, 
      Hubei Province, China.
FAU - Chen, Xiao
AU  - Chen X
AD  - Department of Ophthalmology, Wuhan School of Clinical Medicine, Southern Medical 
      University (Wuhan General Hospital of Guangzhou Military Region), Wuhan 430060, 
      Hubei Province, China.
FAU - Hong, Ling
AU  - Hong L
AD  - Department of Ophthalmology, Wuhan School of Clinical Medicine, Southern Medical 
      University (Wuhan General Hospital of Guangzhou Military Region), Wuhan 430060, 
      Hubei Province, China.
LA  - eng
PT  - Journal Article
DEP - 20190318
PL  - China
TA  - Int J Ophthalmol
JT  - International journal of ophthalmology
JID - 101553860
PMC - PMC6423379
OTO - NOTNLM
OT  - anti-vascular endothelial growth factor
OT  - diabetic macular edema
OT  - outer retinal tabulation
OT  - spectral-domain optical coherence tomography
EDAT- 2019/03/29 06:00
MHDA- 2019/03/29 06:01
PMCR- 2019/03/18
CRDT- 2019/03/29 06:00
PHST- 2018/09/02 00:00 [received]
PHST- 2019/01/02 00:00 [accepted]
PHST- 2019/03/29 06:00 [entrez]
PHST- 2019/03/29 06:00 [pubmed]
PHST- 2019/03/29 06:01 [medline]
PHST- 2019/03/18 00:00 [pmc-release]
AID - ijo-12-03-442 [pii]
AID - 10.18240/ijo.2019.03.15 [doi]
PST - epublish
SO  - Int J Ophthalmol. 2019 Mar 18;12(3):442-450. doi: 10.18240/ijo.2019.03.15. 
      eCollection 2019.