Comparision of Hyperreflective Foci after Treatment of Diabetic Macular Edema Patients between Intravitreal Injections

초록

Purpose: To compare the outcomes in patients with diabetic macular edema (DME) treated with intravitreal dexamethasone implants and intravitreal bevacizumab injections. Methods: A retrospective cohort study was designed using 66 patients with DME treated with intravitreal dexamethasone (n = 35; 35 eyes) and intravitreal bevacizumab (n = 31; 31 eyes). Post-treatment changes in hyperreflective foci in the inner and outer retina were characterized using optical coherence tomography, central macular thickness, outer limiting membrane, and photo-receptor inner segment-outer segment junctions. Visual acuities were analyzed 4 weeks after bevacizumab injections and 8 weeks after dexamethasone injections. Results: Both groups showed a decrease in the number of hyperreflective foci after treatment: from 10.6 +/- 11.8 to 6.3 +/- 5.9 (p = 0.005) in the intravitreal dexamethasone implant group and from 11.6 +/- 8.5 to 7.7 +/- 6.7 (p < 0.001) in the intravitreal bevacizumab injection group. The mean central macular thickness in the dexamethasone group changed significantly from 586.8 mu m to 297.7 mu m after treatment and the visual acuity improved significantly from 0.33 logMAR to 0.38 logMAR after treatment (p < 0.001 and p = 0.018, respectively). The mean central macular thickness in the bevacizumab group showed a significant decrease from 467.1 mu m to 353.2 mu m after treatment (p < 0.001), but there was no significant change in the visual acuities: 0.34 logMAR to 0.32 logMAR after treatment (p = 0.464). Conclusions: Both intravitreal dexamethasone implants and bevacizumab treatments in patients with DME showed improved outcomes including a decrease in hyperreflective foci shown by optical coherence tomography.

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