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Comparision of Hyperreflective Foci after Treatment of Diabetic Macular Edema Patients between Intravitreal Injections
당뇨황반부종에서 유리체 내 주사제에 따른 치료 전후 고반사점 변화 비교
JKOS 2020 Jan;61(1):41-50
Published online January 15, 2020;  https://doi.org/10.3341/jkos.2020.61.1.41
Copyright © 2020 The Korean Ophthalmological Society.
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Minjin Kim, MD1, Kibum Park, MD1, Myeong Yeon Yi, MD2, Sung Jin Lee, MD, PhD1
김민진1 · 박기범1 · 이명연2 · 이성진1

Department of Ophthalmology, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine1, Seoul, Korea
Soo Eye Clinic2, Seoul, Korea
순천향대학교 의과대학 서울병원 안과학교실1, 수안과의원2
Received July 4, 2019; Revised August 16, 2019; Accepted December 30, 2019.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
 Abstract
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 photoreceptor 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 µm to 297.7 µm 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 µm to 353.2 µm 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.
Keywords : Bevacizumab, Dexamethasone, Diabetic macular edema, Hyperreflective foci

 

February 2020, 61 (2)