The effect of intravitreal anti-VEGF injections on choroidal vascular index in patients with diabetic macular edema

Abstract

Purpose

This study aims to examine and compare the effects of intravitreal bevacizumab injection (IVB) at subfoveal 1500 micron (μm) and submacular 6000 μm in patients with diabetic macular edema (DME).

Methods

Fifty eyes of 45 patients with DME who completed six doses of IVB were included in the study group, and 50 eyes of 42 patients who had diabetic retinopathy (DR) but did not receive any treatment were included in the control group. Central macular thickness (CMT), central choroidal thickness (CCT), subfoveal and total choroidal area (TCA), and choroidal vascular index (CVI) were calculated and their changes at zero, three and six months were evaluated.

Results

At baseline, CVI was significantly lower in both the subfoveal and total macular areas in the study group (p = 0.004, p = 0.003). In the study group, a significant decrease was observed in CVI between zero and six months in the subfoveal area (p = 0.001). In the submacular area, the decrease in CVI in the study group was significant between zero to three months and zero to six months. There was moderate correlation between measurements of CVI in the subfoveal and total macular areas (r = 0.66, p < 0.001).

Conclusion

These findings indicate that intravitreal bevacizumab injection reduces the CVI and the effects of intravitreal anti-VEGF on CVI emerge earlier and more prominently in the submacular 6000 µm area.

Keywords:

• Choroidal vascular index
• anti-VEGF
• diabetic macular edema
• intravitreal bevacizumab
• diabetes mellitus

Authors’ contributions

Aydin Toprak: Writing – review & editing, Writing – original draft, Supervision, Resources, Project administration, Methodology, Conceptualisation. Hakan Koc: Supervision, Resources, Project administration, Methodology, Conceptualisation. Atilla Alpay: Writing – review & editing, Supervision, Resources, Project administration, Methodology, Conceptualisation. Suat Hayri Ugurbas: Supervision, Resources, Project administration, Methodology, Conceptualisation.

Availability of data and materials

The datasets used and/or analysed during the current study are available from the corresponding author upon reasonable request.

Ethics approval and consent to participate

This study was approved by the Non-Interventional Clinical Research Ethics Committee of Zonguldak Bulent Ecevit University (23/02/2022 no:2022/04) and conducted according to the tenets of the Declaration of Helsinki. Informed consent was obtained from each participant before their participation.

Disclosure statement

Aydin Toprak declares that he has no conflict of interest. Hakan Koc declares that she has no conflict of interest. Atilla Alpay declares that he has no conflict of interest. Suat Hayri Ugurbas declares that he has no conflict of interest.

Additional information

Funding

The author(s) reported there is no funding associated with the work featured in this article.