부산대학교 도서관

Purpose: To assess the utility of pre‑defined imaging biomarkers on optical coherence tomography (OCT) and OCT angiography (OCTA) in patients with diabetic macular edema (DME) following anti‑vascular endothelial growth factor (anti‑VEGF) therapy in determining visual and anatomical outcomes. Methods: In this prospective, non‑randomized, and interventional study, 17 patients with treatment‑naive DME were included. OCT biomarkers [size/reflectivity of cysts, disorganization of retinal inner layers, integrity of ellipsoid zone or external limiting membrane, subfoveal serous retinal detachment, hyper‑reflective foci (HRF)] and OCTA [vascular density (VD), foveal avascular zone (FAZ), and total micro‑aneurysms in superficial capillary plexus and deep capillary plexus (DCP)] were analyzed at baseline and after three monthly intravitreal anti‑VEGF injections. Response was defined as a decrease of 10% or more in central macular thickness from the baseline after three injections. Results: 13/17 (76.47%) patients were categorized as responders to anti‑VEGF therapy. Non‑responders had significantly greater hyper‑reflectivity of cysts (P = 0.015), larger cystic spaces (P = 0.023), and an increased number of HRF (P = 0.04) at baseline. On OCTA, non‑responders showed larger FAZ in DCP (1.35 ± 0.21 versus 1.14 ± 0.28 mm² ) (P = 0.042) and lower VD (61.17 ± 0.45 versus 62.73 ± 3.32) in DCP at baseline. At 3 months, the VD increased in responders (63.10 ± 3.42) compared to a decrease in non‑responders (60.82 ± 1.13) (P = 0.032). Conclusions: Non‑responders show a higher number of micro‑aneurysms, larger FAZ, and lower VD in the DCP on OCTA and higher cyst hyper‑reflectivity and HRF and larger cystic spaces on OCT imaging [ABSTRACT FROM AUTHOR]