Changes in Macular Oedema by Optical Coherence Tomography in Patients Receiving Intravitreal Bevacizumab: A Retrospective Observational Hospital Based Study NC05-NC09
Dr. Nimisha Lahkar,
Junior Resident, Department of Ophthalmology, Bharati Vidyapeeth (Deemed to be University) Medical College and Hospital, Sangli, Maharashtra, India.
Introduction:Collection of fluid in the macula is called macular oedema. It is a manifestation of various pathologies, main being diabetic retinopathy. Since the burden of the disease is immense and can cause blindness, its early detection and treatment are of utmost necessity. Optical Coherence Tomography (OCT) is a fast, efficacious and easy diagnostic tool for detecting macular oedema at the earliest and hence is used widely now. Intravitreal Injection Bevacizumab (IVB) is an anti Vascular Endothelial Growth Factor (anti-VEGF) agent effective in the treatment of macular oedema and is cost effective compared to its contemporaries.
Aim: To study the clinical effectiveness of IVB as measured by Spectral Domain-Optical Coherence Tomography (SD-OCT) changes in macular thickness in patients with macular oedema.
Materials and Methods: This was a retrospective analysis of 32 eyes of 30 patients with macular oedema due to various retinal pathologies that underwent IVB and followed-up for a period of minimum 6 months. The outcomes were measured on SD-OCT at baseline then at one month, three months and six months. Morphological changes were also analysed through the OCT pictures. Paired t-test and chi-square test were used for statistical analysis.
Results: The Central Foveal Thickness (CFT) reduced from 445.28Â±155.87 Âµm at baseline to 334.44Â±100.42 Âµm at one month which was statistically significant (p<0.001) and the Parafoveal Thickness (PFT) reduced from 452.70Â±131.95 Âµm at baseline to 353.09Â±100.92 Âµm at one month which was also statistically significant (p<0.001). This decrease in macular oedema continued at three months and six months follow-up. The improvement in visual acuity was also significant from baseline to one month and six months follow-up. Sixteen eyes (50%) received a second injection and 9 (28.12%) eyes received a third injection as well. None of the patients showed serious ocular and systemic side-effects of the drug in the present study. Along with the retinal thickness, morphological changes in OCT biomarkers namely cystoid spaces, Hyper-Reflective Foci (HRF), Serous Macular Detachment (SMD) and Ellipsoid Zones (EZ) were also analysed at baseline then at one, three and six months follow-up.
Conclusion: IVB has promising morphometric and functional outcomes in macular oedema of various retinal pathologies as a primary treatment modality in real world scenario.