Evaluation Of Ozurdex In The Treatment Of Diabetic Macular Edema By OCTA

Objective:To evaluate,using optical coherence tomography angiography(OCTA),the short-term efficacy of intravitreal dexamethasone(DEX)implant in patients with diabetic macular edema(DME)Methods:We collected 44 patients(44 eyes)with DME diagnosed by fundus fluorescence angiography(FFA)or optical coherence tomography(OCT)from October 2020 to October 2022 in the Second Affiliated Hospital of Nanchang University for a retrospective analysis and study.The treatment plan is to inject dexamethasone sustained-release into the vitreous cavity.The best corrected visual acuity(BVCA)were recorded before treatment and followed up 1 month,3 months,and 6 months after treatment.BCVA was recorded by ETDRS(Early Treatment Study of diabetes Retinopathy)visual chart.Using OCTA to measure the retinal structure of a 6*6mm area centered on the fovea of the macula.Recording the central macular thickness(CMT),the area of the foveal avascular area(FAZ),and the vascular density of superficial and deep retinal capillaries.Comparing the changes before and after treatment and the correlation between the changes.Results:After DME patients treated with intravitreal injection of dexamethasone sustained-release agent,the BCVA was increased from 1 month,3 months,6 months after treatment comparing the baseline.The difference is statistically significant.The baseline BCVA before treatment was 0.98±0.32 Log MAR,The BCVA is 0.70±0.30Log MAR after 1 month of treatment,P<0.001.The BCVA is 0.57±0.34 Log MAR after 3months of treatment,P<0.001.The BCVA is 0.58±0.24 after 6 months of treatment,P<0.001.The CMT was decreased from 1 month,3 months,6 months after treatment comparing the baseline.The difference is statistically significant.The baseline CMT before treatment was 476.30±144.74μm.The CMT is 476.30±144.74μm after 1 month of treatment,P=0.02.The CMT is 279.64±92.61μm after3 months of treatment,P<0.001.The CMT is 269.67±87.06μm in 6 months after treatment,P<0.001.During the follow-up period,the FAZ area reduced at 1 month,3 months,and 6 months after treatment,The baseline FAZ area before treatment was0.34±0.16μm ~2,decreased to 0.27±0.10μm ~2 after 1 month of treatment,P=0.002.The FAZ is 0.26±0.12μm ~2 after 3 months of treatment,P=0.003,The FAZ is 0.25±0.10μm ~2 after 6 months of treatment,P<0.001.Compared with before treatment,the vascular density of superficial retinal capillaries increased at 1 month,3months,and 6 months after treatment,The baseline vessel density before treatment was 38.50±5.63%.The vascular density is 39.75±5.34%after 1 month of treatment,P=0.02.The vascular density is39.89±5.51%after 3 months of treatment,P=0.04.The vascular density is 39.78±5.41%after 6 months of treatment,P=0.02.However,there was no significant improvement in the density of deep retinal capillaries before and after treatment during the follow-up period.There is a correlation between baseline FAZ size and VD of shallow and deep retinal capillaries(r=-0.591,P=0.000;r=-0.509,P=0.000),and a positive correlation between the changes in BCVA and CMT(r=0.821,P<0.05).Conclusion:Ozurdex can safely and effectively treat diabetes macular edema.BCVA is higher than that before treatment,CMT is lower than that before treatment,and FAZ area is lower than that before reatment.Among them,CMT reduction and FAZ area reduction are related factors of BCVA increase.