{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,6]],"date-time":"2026-05-06T21:30:28Z","timestamp":1778103028271,"version":"3.51.4"},"reference-count":22,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2019,1]]},"abstract":"<jats:sec>\n            <jats:title>Purpose:<\/jats:title>\n            <jats:p>To evaluate the effects of anti\u2013vascular endothelial growth factor treatment on retinal fluid in patients with diabetic macular edema by using optical coherence tomography leakage (OCT-L), a new method of quantifying sites of lower than normal optical reflectivity (LOR) in OCT, and to correlate these findings with best-corrected visual acuity (BCVA) response.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods:<\/jats:title>\n            <jats:p>Prospective analysis of 21 eyes with diabetic macular edema, naive to anti\u2013vascular endothelial growth factor treatment. Macular cube 512 \u00d7 128 and OCT angiography 6 \u00d7 6-mm scans (CIRRUS AngioPlex; ZEISS, Dublin, CA) were acquired in all eyes before the first ranibizumab injection (V1) and 1 week after treatment (V2). Optical coherence tomography leakage analysis was performed with Angioplex raw scan data used to calculate LOR map ratios. Lower optical reflectivity ratios at baseline and differences from V1 to V2 and other OCT morphological features such as central retinal thickness measurements, disorganization of the inner retinal layers, and disruption of ellipsoid zone were compared with BCVA response 1 month after the first intravitreal injection.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results:<\/jats:title>\n            <jats:p>After the first intravitreal injection of ranibizumab, eight patients (38%) were identified as good responders, 5 (24%) as moderate, and 8 (38%) as poor. There were no significant BCVA differences at baseline. Significant differences were found in LOR ratio changes between the different treatment response groups after 1 week of treatment, especially in outer segment and outer plexiform layer (outer segment\u2014good responders: \u221253%, responders: \u221212%, and poor responders: 7% [<jats:italic toggle=\"yes\">P<\/jats:italic> = 0.026]; outer plexiform layer\u2014good responders: \u221249%, responders: 18%, and poor responders: 5% [<jats:italic toggle=\"yes\">P<\/jats:italic> = 0.010]). Lower optical reflectivity ratios differences after 1 week of treatment predict better the BCVA treatment response at 1 month than changes of central retinal thickness, disorganization of the inner retinal layer, and ellipsoid zone disruption, especially in the outer segment and outer plexiform layer (area under the curve = 0.82 and 0.73, respectively).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusion:<\/jats:title>\n            <jats:p>Optical coherence tomography leakage changes after anti\u2013vascular endothelial growth factor treatment of diabetic macular edema, identifying the degree of decrease in retinal fluid in the outer layers of the retina is a more robust biomarker of BCVA recovery than central retinal thickness, disorganization of the inner retinal layer, or ellipsoid zone disruption changes.<\/jats:p>\n          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Image (AIBILI), Coimbra, Portugal;"}]},{"given":"Jo\u00e3o","family":"Figueira","sequence":"additional","affiliation":[{"name":"Association for Innovation and Biomedical Research on Light and Image (AIBILI), Coimbra, Portugal;"},{"name":"Faculty of Medicine, University of Coimbra, Coimbra, Portugal; and"},{"name":"Department of Ophthalmology, Centro Hospitalar e Universit\u00e1rio de Coimbra (CHUC), Coimbra, Portugal."}]},{"given":"Rufino","family":"Silva","sequence":"additional","affiliation":[{"name":"Association for Innovation and Biomedical Research on Light and Image (AIBILI), Coimbra, Portugal;"},{"name":"Faculty of Medicine, University of Coimbra, Coimbra, Portugal; and"},{"name":"Department of Ophthalmology, Centro Hospitalar e Universit\u00e1rio de Coimbra (CHUC), Coimbra, Portugal."}]},{"given":"Jos\u00e9 G.","family":"Cunha-Vaz","sequence":"additional","affiliation":[{"name":"Association for Innovation and Biomedical Research on Light and Image (AIBILI), Coimbra, Portugal;"},{"name":"Faculty of Medicine, University of Coimbra, Coimbra, Portugal; and"}]}],"member":"276","reference":[{"key":"R1-20230816","doi-asserted-by":"crossref","first-page":"552","DOI":"10.1001\/archopht.122.4.552","article-title":"The prevalence of diabetic retinopathy among adults in the United States","volume":"122","author":"Kempen","year":"2004","journal-title":"Arch Ophthalmol"},{"key":"R2-20230816","doi-asserted-by":"crossref","first-page":"1275","DOI":"10.1517\/13543784.13.10.1275","article-title":"The role of growth factors in the pathogenesis of diabetic retinopathy","volume":"13","author":"Grant","year":"2004","journal-title":"Expert Opin Investig Drugs"},{"key":"R3-20230816","doi-asserted-by":"crossref","first-page":"151","DOI":"10.1177\/2042018813512360","article-title":"Anti-vascular endothelial growth factor therapy for diabetic macular edema","volume":"4","author":"Boyer","year":"2013","journal-title":"Ther Adv Endocrinol 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edema","volume":"57","author":"Cunha-Vaz","year":"2016","journal-title":"Invest Ophthalmol Vis Sci"},{"key":"R14-20230816","first-page":"5953","article-title":"Feasibility of automated interface segmentation of Cirrus HD-OCT data in normal and mild non proliferative diabetic retinopathy eyes","volume":"56","author":"Santos","year":"2015","journal-title":"Invest Ophthalmol Vis Sci"},{"key":"R15-20230816","doi-asserted-by":"crossref","first-page":"820","DOI":"10.1001\/jamaophthalmol.2015.0972","article-title":"Association of disorganization of retinal inner layers with vision after resolution of center-involved diabetic macular edema","volume":"133","author":"Radwan","year":"2015","journal-title":"JAMA Ophthalmol"},{"key":"R16-20230816","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1007\/s00417-010-1452-4","article-title":"Meta-analysis and review on the effect of bevacizumab in diabetic macular edema","volume":"249","author":"Goyal","year":"2011","journal-title":"Graefes Arch 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