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已发表论文
抗 VEGF 治疗累及黄斑中心糖尿病性黄斑水肿后与视觉结局相关的区域特异性视网膜和脉络膜生物标志物
Authors Qu Y , Wan H, Zhou H, Jiang X, Shi X, Xing X, Wei J, Shen Y, Liu K
Received 10 September 2025
Accepted for publication 17 December 2025
Published 12 January 2026 Volume 2026:20 566570
DOI https://doi.org/10.2147/OPTH.S566570
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 4
Editor who approved publication: Dr Yousef Fouad
Yuan Qu,1,2,* Hancong Wan,1,2,* Hao Zhou,1,2 Xujun Jiang,1,2 Xin Shi,1,2 Xindan Xing,1,2 Jin Wei,1,2 Yinchen Shen,1,2 Kun Liu1,2
1Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200080, People’s Republic of China; 2National Clinical Research Center for Eye Diseases; Shanghai Key Laboratory of Ocular Fundus Diseases; Shanghai Engineering Center for Visual Science and Photomedicine; Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Diseases; Shanghai Clinical Research Center for Eye Diseases; Shanghai Key Clinical Specialty, Shanghai, 200080, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Yinchen Shen, Email shen_yinchen@163.com
Objective: This investigation sought to: (1) characterize anti-vascular endothelial growth factor (VEGF) therapy-induced choroidal structural modifications in center-involved diabetic macular edema (CI-DME) utilizing swept-source optical coherence tomography (SS-OCT) imaging, and (2) assess the predictive capacity of choroidal morphometric indices for visual functional prognosis.
Methods and Analysis: This retrospective cohort study encompassed CI-DME patients received intravitreal anti-VEGF injections. Structural parameters, including retinal thickness, choroidal thickness, and choroidal vascularity index (CVI), were measured by SS-OCT pre- and post-treatment. Statistical evaluations included paired t-tests, Wilcoxon tests, Elastic Net regression, sensitivity analyses and prognostic analysis. Subgroup analysis was stratified by baseline characteristics.
Results: 58 eyes from 53 CI-DME patients were included. Following a single dose of anti-VEGF injection, logMAR BCVA improved significantly from 0.694 ± 0.342 to 0.614 ± 0.429 (P = 0.0103). Total choroidal volumes within the ETDRS grid decreased by 0.065 mm3 (P = 0.031). Retinal thickness significantly declined in all nine ETDRS subfields (P < 0.001), while choroidal thinning was most prominent in the central (mean deviation: – 17.42 μm, P < 0.001), nasal inner ring (mean deviation: – 15.10 μm, P = 0.0038), and nasal outer ring (mean deviation: – 11.83 μm, P = 0.0249) regions. Elastic Net regression and sensitivity analyses identified changes in central retinal thickness and nasal outer ring choroidal thickness as key imaging biomarkers associated with BCVA gains. Prognostic analysis revealed that baseline nasal inner ring retinal thickness showed most association with post-treatment central retinal thickness, whereas visual acuity outcomes were closely linked to age and baseline temporal outer ring retinal thickness. Exploratory subgroup analyses demonstrated that eyes with thicker retinas and thinner choroids at baseline, as well as younger patients, appeared to receive more favorable ocular structural and visual responses.
Conclusion: SS-OCT imaging revealed region-specific changes of the retinal and choroidal thickness after anti-VEGF treatment, providing a practical reference for monitoring and tracking therapeutic response in CI-DME.
Keywords: center-involved diabetic macular edema, anti-vascular endothelial growth factor therapy, swept-source optical coherence tomography, choroidal vascularity index
1Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200080, People’s Republic of China; 2National Clinical Research Center for Eye Diseases; Shanghai Key Laboratory of Ocular Fundus Diseases; Shanghai Engineering Center for Visual Science and Photomedicine; Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Diseases; Shanghai Clinical Research Center for Eye Diseases; Shanghai Key Clinical Specialty, Shanghai, 200080, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Yinchen Shen, Email shen_yinchen@163.com
Objective: This investigation sought to: (1) characterize anti-vascular endothelial growth factor (VEGF) therapy-induced choroidal structural modifications in center-involved diabetic macular edema (CI-DME) utilizing swept-source optical coherence tomography (SS-OCT) imaging, and (2) assess the predictive capacity of choroidal morphometric indices for visual functional prognosis.
Methods and Analysis: This retrospective cohort study encompassed CI-DME patients received intravitreal anti-VEGF injections. Structural parameters, including retinal thickness, choroidal thickness, and choroidal vascularity index (CVI), were measured by SS-OCT pre- and post-treatment. Statistical evaluations included paired t-tests, Wilcoxon tests, Elastic Net regression, sensitivity analyses and prognostic analysis. Subgroup analysis was stratified by baseline characteristics.
Results: 58 eyes from 53 CI-DME patients were included. Following a single dose of anti-VEGF injection, logMAR BCVA improved significantly from 0.694 ± 0.342 to 0.614 ± 0.429 (P = 0.0103). Total choroidal volumes within the ETDRS grid decreased by 0.065 mm3 (P = 0.031). Retinal thickness significantly declined in all nine ETDRS subfields (P < 0.001), while choroidal thinning was most prominent in the central (mean deviation: – 17.42 μm, P < 0.001), nasal inner ring (mean deviation: – 15.10 μm, P = 0.0038), and nasal outer ring (mean deviation: – 11.83 μm, P = 0.0249) regions. Elastic Net regression and sensitivity analyses identified changes in central retinal thickness and nasal outer ring choroidal thickness as key imaging biomarkers associated with BCVA gains. Prognostic analysis revealed that baseline nasal inner ring retinal thickness showed most association with post-treatment central retinal thickness, whereas visual acuity outcomes were closely linked to age and baseline temporal outer ring retinal thickness. Exploratory subgroup analyses demonstrated that eyes with thicker retinas and thinner choroids at baseline, as well as younger patients, appeared to receive more favorable ocular structural and visual responses.
Conclusion: SS-OCT imaging revealed region-specific changes of the retinal and choroidal thickness after anti-VEGF treatment, providing a practical reference for monitoring and tracking therapeutic response in CI-DME.
Keywords: center-involved diabetic macular edema, anti-vascular endothelial growth factor therapy, swept-source optical coherence tomography, choroidal vascularity index