Macular microvascular changes after intravitreal bevacizumab injection in diabetic macular edema
Reza Mirshahi1 , Khalil Ghasemi Falavarjani 2 *, Pasha Anvari 2
- Eye Research Center, The Five Senses Institute, Iran University of Medical Sciences, Tehran, Iran.
- Eye Research Center, The Five Senses Institute, Rassoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
Abstract: To evaluate the changes in retinal capillary plexus and the choriocapillaris after a single intravitreal injection of bevacizumab in eyes with diabetic macular edema using optical coherence tomography angiography (OCTA).
Methods: In this prospective interventional case series, eyes with center-involving diabetic macular edema were enrolled. Vascular density (VD), vessel diameter index (VDI), vessel length density (VLD), foveal avascular zone (FAZ) area and foveal density (FD)-300 were measured using en face OCTA images before and 1 month following administration of intravitreal bevacizumab. VD and VDI measurements were performed in the superficial (SCP) and deep retinal capillary plexus (DCP) and in the choriocapillaris. Additionally, capillary non-perfusion area (CNPA) was detected automatically based on vessel distance map in 4 concentric rings around the foveal center. The segmentation error was manually corrected and the measurements were performed by 2 expert graders.
Results: Twenty-three eyes of 19 patients with a mean age of 62.76±6.88 were included. There were no significant changes in the FAZ area, FD-300 or in the VD of the foveal and parafoveal SCP and DCP. Also, VLD and VDI of the SCP and DCP remained unchanged. The change in the CNPA was not statistically significant. The VD of choriocapillaris increased significantly after injections (P=0.005).
Conclusion: FAZ area and vascular density of the retinal capillary plexus remained stable in the short-term period after intravitreal bevacizumab. In addition, the choriocapillaris blood flow improved after bevacizumab injection.
