title: Effect of anti-vascular endothelial growth factor therapy on choroidal thickness in diabetic macular edema.
abstract: OBJECTIVE
  To determine the effect of anti-vascular endothelial growth factor (VEGF) therapy on choroidal thickness in eyes with diabetic macular edema (DME).
  
  
  METHODS
  A retrospective, cohort analysis of 59 eyes from 59 patients with DME without prior anti-VEGF therapy.
  
  
  METHODS
  Choroidal thickness was measured using semiautomated segmentation of enhanced depth imaging optical coherence tomography images at 0.5-mm intervals from 2.5 mm nasal to 2.5 mm temporal to the fovea. Changes in choroidal thickness with and without anti-VEGF treatment over 6 months were compared. Best-corrected visual acuity and central foveal thickness were analyzed to evaluate the association of choroidal thickness with functional and anatomic outcomes.
  
  
  RESULTS
  Of the 59 eyes with DME, 26 eyes were observed without treatment, whereas 33 underwent intravitreal anti-VEGF therapy (mean number of injections, 2.73) over 6 months. In untreated eyes, there was no significant change in best-corrected visual acuity (P = .098), central foveal thickness (P = .472), or choroidal thickness at all measurements along the macula (P = .057 at the fovea). In eyes treated with anti-VEGF injections, choroidal thickness decreased significantly at the fovea (246.6 to 224.8 μm; P < .001) and at 0.5 mm nasal (240.9 to 221.9 μm; P = .002) and 0.5 mm temporal (249.3 to 224.8 μm; P = .011) to the fovea. The decrease in subfoveal choroidal thickness after anti-VEGF treatment was not associated with the cumulative number of anti-VEGF injections (R(2) = 0.031; P = .327) or to changes in best-corrected visual acuity (R(2) = 0.017; P = .470) or central foveal thickness (R(2) = 0.040; P = .263).
  
  
  CONCLUSIONS
  Central choroidal thickness decreases after anti-VEGF therapy for DME after 6 months, but may not be associated with functional or anatomic outcomes in eyes with DME.
authors: Department of Ophthalmology, Duke University Medical Center, Durham, North Carolina.
authors: Glenn
authors: G
authors: Yiu
authors: Department of Ophthalmology, Duke University Medical Center, Durham, North Carolina.
authors: Varsha
authors: V
authors: Manjunath
authors: Department of Biomedical Engineering, Duke University, Durham, North Carolina.
authors: Stephanie J
authors: SJ
authors: Chiu
authors: Department of Ophthalmology, Duke University Medical Center, Durham, North Carolina; Department of Biomedical Engineering, Duke University, Durham, North Carolina.
authors: Sina
authors: S
authors: Farsiu
authors: Department of Ophthalmology, Duke University Medical Center, Durham, North Carolina. Electronic address: tamer.mahmoud@duke.edu.
authors: Tamer H
authors: TH
authors: Mahmoud
mesh_terms: D020533:Angiogenesis Inhibitors / Q000627:therapeutic use*; D002829:Choroid / Q000473:pathology*; D015331:Cohort Studies; D003930:Diabetic Retinopathy / Q000188:drug therapy*; D005260:Female; D006801:Humans; D058449:Intravitreal Injections; D008269:Macular Edema / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D009929:Organ Size; D012189:Retrospective Studies; D041623:Tomography, Optical Coherence; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors*; D014792:Visual Acuity / Q000502:physiology
chemical_list: D020533:Angiogenesis Inhibitors; C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A