ArticleBMC ophthalmology2026
Early dynamic response on spectral-domain OCT predicts long-term visual outcome in diabetic macular edema treated with aflibercept.
Article in BMC ophthalmology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectiveA retrospective evaluation of the long-term visual recovery prediction in patients with diabetic macular edema (DME) following aflibercept treatment, based on spectral-domain optical coherence tomography (SD-OCT) parameters at one and four months post-treatment.
methodsThis study involved 112 eyes of 112 DME patients which received at least one injection of aflibercept. SD-OCT parameters at 1 and 4 months post-aflibercept treatment-including central subfield thickness (CST), the continuity of external limiting membrane (ELM)/ellipsoid zone (EZ) and cone outer segment tip (COST), as well as the counts of retinal hyperreflective retinal foci (HRF), along with best-corrected visual acuity (BCVA) improvement at 12 months post-treatment-were analyzed. The correlation between SD-OCT parameters and BCVA improvement was evaluated using the chi-square or Wilcoxon test, and the predicted value of SD-OCT parameters was assessed via receiver operating characteristic (ROC) curve and binary logistic regression model.
resultsTwelve months after aflibercept treatment, BCVA was improved from 0.66 ± 0.46 to 0.48 ± 0.42 logMAR (p = 0.002). The SD-OCT parameters were significantly improved: CST was decreased from 397.05 ± 199.60 to 289.08 ± 119.39 μm; the affected eyes with damaged ELM/EZ and COST decreased from 46 (41.1%) and 71 (63.4%) to 31 (27.7%) and 43 (38.4%), respectively; the number of HRF decreased from 11.00 ± 11.38 to 8.03 ± 9.58. The AUC values for predicting BCVA gain of ≥ 5 letters at 12 months based on SD-OCT parameters at 1 and 4 months post-aflibercept treatment and their combination were 0.812, 0.824, and 0.873, respectively. Multivariate logistic analysis revealed that CST, ELM/EZ, COST, and HRF at 1 and 4 months were all independent predictors of long-term visual improvement outcomes.
conclusionIntravitreal injection of aflibercept can effectively improve the vision and fundus structure of DME patients. Improvements in short- and medium-term CST, ELM/EZ, COST integrity, and HRF values are key physiological indicators for visual recovery.
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