Correlation between Visual Acuity and Optical Coherence Tomography-Measured Retinal Thickness in Diabetic Macular Edema

Abstract

Background and Objective: Diabetic macular edema (DME) is one of the common complications of diabetes which significantly accounts for preventable visual impairment and blindness. Central macular thickness (CMT) is a feature found in DME patients. This study aims to determine the relationship between optical coherence tomography (OCT)-measured CMT and visual acuity (VA) in patients with DME before and after intravitreal injection of bevacizumab. Methods: This cross-sectional study was conducted on 100 patients with diabetic macular edema with involvement of both eyes referred to the Ophthalmology Department of Rouhani Hospital in Babol who underwent intravitreal injection of Bevacizumab. VA (measured by Snellen chart), CMT (measured by OCT), clinical and paraclinical factors (including the duration of diabetes, glycosylated hemoglobin (HbA1c), fasting blood sugar (FBS), hypertension, and smoking history data) were evaluated and compared among all patients just before and 45 days after Bevacizumab injection. Findings: Before the injection of Bevacizumab in 200 eyes, the mean value of VA (letter score) and mean value of CMT (µm) were 36.83±12.73 and 425.48±85.18 µm, respectively (p<0.001, 95% CI=12.5 – 17.5 and 95% CI=-71.5 – -55.5, respectively). 45 days after Bevacizumab injection, the mean value of absolute VA changes was 15.24±10.16, and the mean value of absolute CMT changes was -67.83±43.08 µm (coefficient=-0.18, 95% CI=-0.39 – 0.05). Conclusion: Although VA was correlated moderately with CMT and the polynomial regression model enhanced the predictive ability, it remains fully obvious that CMT and clinical factors could play an essential role as VA surrogates.

Keywords

• diabetic retinopathy
• bevacizumab
• visual acuity.