Analysis of retinal layer thickness in diabetic macular oedema treated with ranibizumab or triamcinolone

PurposeTo evaluate detailed changes in retinal layer thickness in spectral-domain optical coherence tomography (SD-OCT) images during a 1-year follow-up of patients treated for diabetic macula oedema (DME). MethodsPost hoc analysis of retinal layer thickness changes applying the automated layer segmentation of SD-OCT images in eyes with DME that were randomly assigned to receive pro re nata (PRN) treatment with either 0.5mg ranibizumab or 8mg triamcinolone. In each patient, seven retinal layers were segmented in 49 scans covering a 20 degrees x20 degrees area of the macula at baseline and after 1year of treatment. Changes in individual layer thickness were correlated with visual acuity (VA) and compared between treatment arms. ResultsTwenty-five patients (seven female, 60.215.1years) were evaluated. Thickness decrease of retinal nerve fibre layer (RNFL) was associated with a gain in VA over 12months (r>0.54; p<0.05). Decrease in ganglion cell layer (GCL) and GCL+IPL thickness pooled for nasal Early Treatment of Diabetic Retinopathy Study (ETDRS) subfields correlated with VA as follows: ranibizumab r=0.74 (GCL) and r=0.63 (GCL+IPL); and triamcinolone r=0.45 (GCL) and r=0.46 (GCL+IPL). ConclusionIn DME therapy, reduction in RNFL thickness may have a considerable impact on retinal function, unrelated to the type of pharmacological treatment. Precise morphologic quantification of neurosensory layers by SD OCT offers new insight into disease pathology and therapeutic targets.