Fundus Autofluorescence in the Evaluation of Diabetic Macular Edema Treatment Response

Introduction: Fundus autofluorescence (FAF) has shown sensitivity in the detection of macular edema.

Objectives: To evaluate indices formed with FAF and retinal anatomical-functional variables in patients with diabetic macular edema (DME) treated with ziv-aflibercept (ziv-AFL).

Methods: Twenty-nine eyes of 15 DME patients who received ziv-AFL intravitreal injections were included in the study. Best-corrected visual acuity (BCVA), contrast sensitivity (CS), optical coherence tomography (OCT) and FAF were evaluated before treatment and at one and two months. OCT variables were central subfield thickness (CST), macular volume (MV) and macular cube average thickness (MCAT). FAF/BCVA, FAF/CS, FAF/CST, FAF/MV and AF/MCAT indices baseline values were obtained. Analysis was performed with Spearman's rank correlation coefficient and linear regression analysis.

Results: There was a significant correlation between baseline FAF/BCVA index and BCVA at second month (r = - 0.78, p = 0.000), between baseline FAF/CS index and BCVA at second month (r = -0.68, p = 0.0009) and between baseline FAF/CS index and MV at first month of follow-up (r = 0.64, p = 0.002).

Conclusions: In DME, composite indices with baseline FAF predict variables such as BCVA in the follow-up of patients receiving ziv-AFL.