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ORIGINAL ARTICLE
Year : 2018  |  Volume : 111  |  Issue : 3  |  Page : 102-107

The relation between inner segment/outer segment junction and visual acuity before and after ranibizumab in diabetic macular edema


Lecture Ophthalmology, Faculty of Medicine, Ain Sham University, Cairo, Egypt

Correspondence Address:
Dr. Reham F. Abd El-Razek El-Shinawy
4th District, Area No. 3, 5th Settlement, New Cairo, Cairo
Egypt
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ejos.ejos_26_18

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Purpose The aim of the study was to evaluate the relation between the photoreceptor inner segment/outer segment (IS/OS) junction integrity and the best corrected visual acuity (BCVA) and color vision after intravitreal injection of antivascular endothelial growth factor, ranibizumab in patients with diabetic macular edema (DME). Patients and methods This prospective observational interventional study was conducted on 50 eyes of patients with DME. All patients received three doses of intravitreal injection of antivascular endothelial growth factor (ranibizumab) 1 month apart. The photoreceptor IS/OS was evaluated by spectral domain optical coherence tomography and correlated to both BCVA and color vision by the Ishihara pseudoisochromatic 38 plates test. Results There was highly statistically significant improvement of photoreceptor IS/OS integrity after the second (P=0.003) and third injections (P=0.000). There were increases in the percentage of cases that read the color test correctly after each injection, but this increase was found to be not statistically significant when compared to color vision before the first injection. The mean BCVA was 0.96±0.09 SD (logarithm of the minimum angle of resolution) before the first injection. There was a highly statistically significant improvement in the BCVA after first (0.78±0.15), second (0.70±0.15), and third injections (0.64±0.16) (P=0.000). There was a statistically significant relation between color vision and IS/OS after the first injection (P=0.047), but it was a highly statistically significant relation after the second and third injections (P=0.000). BCVA was significantly related to IS/OS after the second and third injection (P=0.017 and 0.000, respectively). Conclusion The continuity of the foveal photoreceptor IS/OS layer evaluated by means of spectral domain optical coherence tomography is a valuble prognostic indicator of visual acuity and color vision outcome in patients with DME.


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