Table 1.
Study design, methods, and results of studies that found stable or improved macular perfusion following injections.
| Study | No. of eyes | Design of study | Imaging modality | Agent used and treatment duration | Outcome measure | Study results | Ref. |
|---|---|---|---|---|---|---|---|
| Ghasemi Falavarjani et al. | 13 eyes of 10 patients with DME | Prospective noncomparative case series | OCTA (Optovue) using VD from machine software | Bevacizumab, Ranibizumab, Aflibercept (1 injection by any) | Change in FAZ area (manual) and VD | FAZ-A increased, and VD of foveal area decreased but nonsignificantly (p>0.05) | [32] |
| Sorour et al. | 55 eyes of 35 patients with DME or PDR | Retrospective case series | OCTA (Optovue) 3 × 3 and 6 × 6 scans with VD of machine | 45.7% Bevacizumab, 42.4% Aflibercept, and 11.9% Ranibizumab | Change in VD after 3 injections | No significant change in VD measurements at 1, 2, and 3 months | [33] |
| Hsieh et al. | 50 eyes of 50 patients with DME | Retrospective case series | OCTA (Optovue) 3 × 3 with custom developed Matlab software for image processing and analysis | Ranibizumab (3 injections) | Change in FAZ-A, FAZ-CI, AVC, vascular tortuosity, and VD | Improvement of FAZ-A (-31%), AVC (-4.3%), and inner (+5.9%) and outer (+8.8%) PF-VD in the SCP, and FAZ-A (-31%), FAZ-CI (-4.2%), and inner (+9.1%) and outer (+9.4%) PF-VD in DCP (p ≤ 0.05) | [34] |
| Conti et al. | 19 eyes of 19 patients with DR | Retrospective case series | OCTA (Optovue) 6 × 6 scan using built-in machine VD | Aflibercept (by 12 months, 26% received monthly while 74% received bimonthly treatment) | Change in FAZ and VD after 6 and 12 months of treatment | FAZ area enlarged from 0.307 to 0.313 mm2, VD dropped from 46.9% to 45.7% (p > 0.05) | [35] |
| Michalska and Heinke | 3 eyes of 3 patients with DME | Retrospective case series | OCTA (Optovue) 3 × 3 scans | Aflibercept (3-5 injections) | Change in built-in machine VD | Insignificant change in VD (p > 0.05) | [36] |
| Zhu et al. | 50 eyes of 50 patients with DME (ischemic and nonischemic) | Prospective case series with predefined outcome measures | OCTA (Optovue) 6 × 6 scan using machine software | Conbercept (3 monthly injections then pro re nata for 3 months) | Change in built-in machine VD and FAZ area | FAZ area significantly decreased and superficial capillary plexus VD increased in ischemic group (both p < 0.05) | [37] |
| Mirshani et al. | 23 eyes of 19 patients with DME | Prospective case series with predefined outcome measures | OCTA (Optovue) 3 × 3 scan using machine software and custom image processing | Bevacizumab (single injection) | Change in built-in machine VD, manual FAZ area, VDI, and VLD index | No significant change in FAZ area, retinal VD, VDI, or VLD (all p > 0.05). Improved subfoveal choriocapillaris VD (p > 0.05) | [38] |
AVC: average vessel caliber; DCP: deep capillary plexus; DME: diabetic macular edema; DR: diabetic retinopathy; FA: fluorescein angiography; FAZ: foveal avascular zone; FAZ-A: foveal avascular zone area; FAZ-CI: foveal avascular zone circulatory index; OCTA: optical coherence tomography angiography; PDR: proliferative diabetic retinopathy; PF: parafoveal; SCP: superficial capillary plexus; VD: vascular density; VDI: vessel diameter index; VLD: vascular length density.