Predictive factors for microvascular recovery after treatments for diabetic retinopathy

BMC Ophthalmol. 2023 Jan 25;23(1):34. doi: 10.1186/s12886-023-02788-6.

Abstract

Background: To identify factors associated with microvascular recovery after intravitreal bevacizumab or panretinal photocoagulation (PRP) in diabetic retinopathy (DR).

Methods: We retrospectively reviewed 320 eyes/patients with DR treated with intravitreal bevacizumab and/or PRP. Two consecutive fluorescein angiographies (FAs) of each eye were compared. The number of microaneurysms and the area of capillary non-perfusion were calculated automatically using ImageJ software. Microvascular recovery was defined as a marked reduction in the numbers of microaneurysms (< 20%) or a marked reduction in the area of capillary non-perfusion (< 50%) in 45-degree fields or a complete regression of new vessels in ETDRS 7 standard fields. Baseline FA findings and changes in the ocular and systemic factors were analyzed.

Results: Twenty-eight (8.8%) of the 320 total eyes were found to meet the criteria of microvascular recovery after the treatments. Multivariate analysis revealed the presence of diffuse capillary telangiectasis (P = .003) and late disc leaking (P = .007) on baseline FA and a reduction of glycated hemoglobin (P = .005) during the follow-up period were predictive factors of microvascular recovery after the treatments. Although the microvascular recovery group presented with a significant improvement of BCVA after the treatments, the baseline BCVA could not predict the microvascular recovery after the treatments.

Conclusions: Diffuse capillary telangiectasis or late disc leaking on baseline FA and improved glycemic control positively predicted the microvascular recovery after treatments for DR.

Keywords: Angiographic findings; Diabetic retinopathy; Microvascular recovery.

MeSH terms

  • Angiogenesis Inhibitors / therapeutic use
  • Bevacizumab / therapeutic use
  • Diabetes Mellitus*
  • Diabetic Retinopathy* / drug therapy
  • Diabetic Retinopathy* / surgery
  • Fluorescein Angiography
  • Humans
  • Intravitreal Injections
  • Laser Coagulation
  • Microaneurysm*
  • Retrospective Studies
  • Tomography, Optical Coherence

Substances

  • Bevacizumab
  • Angiogenesis Inhibitors