title: Baseline choroidal thickness as a predictor for response to anti-vascular endothelial growth factor therapy in diabetic macular edema.
abstract: OBJECTIVE
  To determine the association between baseline subfoveal choroidal thickness and short-term response to intravitreal anti-vascular endothelial growth factor (anti-VEGF) therapy in diabetic macular edema (DME).
  
  
  METHODS
  Retrospective, consecutive case series.
  
  
  METHODS
  Fifty-three eyes from 42 patients diagnosed with treatment-naïve DME were treated with 3 monthly intravitreal injections of ranibizumab or bevacizumab. Serial enhanced depth imaging optical coherence tomography scans were used to measure subfoveal choroidal thickness and central macular thickness (CMT). Anatomic response (CMT decrease ≥ 50 μm) and functional response (best-corrected visual acuity gain ≥ 1 line) were assessed at 3 months follow-up using univariate and multivariate analyses.
  
  
  RESULTS
  After 3 monthly anti-VEGF treatments, subfoveal choroidal thickness decreased significantly (225 μm at baseline, 201 μm at 3 months, P < .0001). The anatomic responder group (32 eyes) had a greater baseline choroidal thickness (243 ± 15 μm) than the nonresponder group (21 eyes, 198 ± 13 μm, P = .03). Similarly, the functional responder group (28 eyes) tended to have a greater baseline subfoveal choroidal thickness (239 ± 12 μm) than the nonresponder group (25 eyes, 211 ± 16 μm, P = .08). Multivariate analyses revealed that a greater baseline subfoveal choroidal thickness was associated with a better anatomic (odds ratio = 1.12 for every 10 μm increase, P = .03) and functional response (odds ratio = 8.45 for >200 μm vs ≤ 200 μm, P = .008).
  
  
  CONCLUSIONS
  Baseline subfoveal choroidal thickness may help predict which patients with DME will respond more favorably in the short term to intravitreal anti-VEGF pharmacotherapy. In this study, eyes with a thicker baseline subfoveal choroidal thickness had better short-term anatomic and functional responses.
authors.affiliation: Retina Service of Wills Eye Hospital, Mid Atlantic Retina, Philadelphia, Pennsylvania.
authors.forename: Nadim
authors.initials: N
authors.lastname: Rayess
authors.affiliation: Retina Service of Wills Eye Hospital, Mid Atlantic Retina, Philadelphia, Pennsylvania.
authors.forename: Ehsan
authors.initials: E
authors.lastname: Rahimy
authors.affiliation: Department of Ophthalmology, University of Pennsylvania, Philadelphia, Pennsylvania.
authors.forename: Gui-Shuang
authors.initials: GS
authors.lastname: Ying
authors.affiliation: Retina Service of Wills Eye Hospital, Mid Atlantic Retina, Philadelphia, Pennsylvania.
authors.forename: Nika
authors.initials: N
authors.lastname: Bagheri
authors.affiliation: Retina Service of Wills Eye Hospital, Mid Atlantic Retina, Philadelphia, Pennsylvania.
authors.forename: Allen C
authors.initials: AC
authors.lastname: Ho
authors.affiliation: Retina Service of Wills Eye Hospital, Mid Atlantic Retina, Philadelphia, Pennsylvania.
authors.forename: Carl D
authors.initials: CD
authors.lastname: Regillo
authors.affiliation: Retina Service of Wills Eye Hospital, Mid Atlantic Retina, Philadelphia, Pennsylvania.
authors.forename: James F
authors.initials: JF
authors.lastname: Vander
authors.affiliation: Retina Service of Wills Eye Hospital, Mid Atlantic Retina, Philadelphia, Pennsylvania. Electronic address: jhsu@midatlanticretina.com.
authors.forename: Jason
authors.initials: J
authors.lastname: Hsu
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D020533:Angiogenesis Inhibitors / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use*; D000068258:Bevacizumab; D002829:Choroid / Q000473:pathology*; D003930:Diabetic Retinopathy / Q000188:drug therapy* / Q000473:pathology; D005260:Female; D006801:Humans; D058449:Intravitreal Injections; D008269:Macular Edema / Q000188:drug therapy* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011237:Predictive Value of Tests; D000069579:Ranibizumab; D012189:Retrospective Studies; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors*; D014792:Visual Acuity; D055815:Young Adult
chemical_list: D020533:Angiogenesis Inhibitors; D061067:Antibodies, Monoclonal, Humanized; D042461:Vascular Endothelial Growth Factor A; D000068258:Bevacizumab; D000069579:Ranibizumab