Retrospective analysis of optical coherence tomography (oct) biomarkers predicting visual outcomes in diabetic macular edema.

Authors

  • Dr . Ipshita Aparajita Nanda Associate professor, Dept of ophthalmology, IQ City Medical College Durgapur, West Bengal Author

DOI:

https://doi.org/10.51168/he3qyf55

Keywords:

Diabetic Macular Edema, Optical Coherence Tomography, OCT Biomarkers, Best Corrected Visual Acuity, Disorganization of Retinal Inner Layers, Ellipsoid Zone

Abstract

Background

Diabetic Macular Edema (DME) is one of the leading causes of visual impairment among patients with diabetic retinopathy. Optical Coherence Tomography (OCT) provides detailed retinal imaging and enables the identification of structural biomarkers associated with visual outcomes. This study aimed to evaluate the association between OCT biomarkers and visual outcomes in patients with DME.

Methods

This retrospective observational study was conducted in the Department of Ophthalmology, IQ City Medical College and Hospital, from December 2024 to June 2026. Medical records of 100 patients diagnosed with DME were reviewed. Demographic characteristics, duration of diabetes, Best Corrected Visual Acuity (BCVA), and OCT findings were collected. OCT biomarkers assessed included Central Macular Thickness (CMT), Disorganization of Retinal Inner Layers (DRIL), Hyperreflective Foci (HRF), Ellipsoid Zone (EZ) disruption, and Subretinal Fluid (SRF). Statistical analysis was performed using SPSS software, with p < 0.05 considered statistically significant.

Results

A total of 100 patients were included. The mean age was 58.6 ± 9.4 years, with 58% males and 42% females. Increased CMT was observed in 88% of patients, HRF in 65%, DRIL in 52%, EZ disruption in 48%, and SRF in 30%. Significant negative correlations were observed between BCVA and CMT (r = −0.55, p < 0.001), DRIL (r = −0.63, p < 0.001), HRF (r = −0.49, p = 0.002), and EZ disruption (r = −0.68, p < 0.001). SRF demonstrated a weak, non-significant association with visual acuity (r = −0.21, p = 0.084).

Conclusion

OCT biomarkers, particularly DRIL and Ellipsoid Zone disruption, were strongly associated with poor visual outcomes in patients with DME and may serve as reliable prognostic indicators for disease monitoring and individualized treatment planning.

Recommendations

Routine assessment of OCT biomarkers should be incorporated into the clinical evaluation of patients with DME to facilitate early risk stratification and optimize treatment decisions.

Author Biography

  • Dr . Ipshita Aparajita Nanda, Associate professor, Dept of ophthalmology, IQ City Medical College Durgapur, West Bengal

    is an Associate Professor in the Department of Ophthalmology at IQ City Medical College and Hospital, Durgapur, West Bengal, India. Her areas of clinical and research interest include diabetic retinopathy, diabetic macular edema, retinal imaging, Optical Coherence Tomography, and medical retina. She has actively contributed to clinical research and academic teaching in ophthalmology.

References

Zur D, Iglicki M, Busch C, Invernizzi A, Mariussi M, Loewenstein A, Cebeci Z, Chhablani JK, Chaikitmongkol V, Couturier A, Fraser-Bell S. OCT biomarkers as functional outcome predictors in diabetic macular edema treated with dexamethasone implant. Ophthalmology. 2018 Feb 1;125(2):267-75. https://doi.org/10.1016/j.ophtha.2017.08.031

Hsieh YT, Alam MN, Le D, Hsiao CC, Yang CH, Chao DL, Yao X. OCT angiography biomarkers for predicting visual outcomes after ranibizumab treatment for diabetic macular edema. Ophthalmology Retina. 2019 Oct 1;3(10):826-34. https://doi.org/10.1016/j.oret.2019.04.02

Visioli G, Alisi L, Mastrogiuseppe E, Albanese GM, Romano E, Iannetti L, Armentano M, Giovannetti F, Gharbiya M. OCT biomarkers as predictors of visual improvement in diabetic macular edema eyes receiving dexamethasone implants. International Journal of Retina and Vitreous. 2023 Jun 14;9(1):35. https://doi.org/10.1186/s40942-023-00473-w

Szeto SK, Hui VW, Tang FY, Yang D, Sun ZH, Mohamed S, Chan CK, Lai TY, Cheung C. OCT-based biomarkers for predicting treatment response in eyes with centre-involved diabetic macular oedema treated with anti-VEGF injections: a real-life retina clinic-based study. British Journal of Ophthalmology. 2023 Apr;107(4):525-33. https://doi.org/10.1136/bjophthalmol-2021-319587

Chang YC, Huang YT, Hsu AY, Meng PP, Lin CJ, Lai CT, Hsia NY, Chen HS, Tien PT, Lin JM, Chen WL. Optical coherence tomography biomarkers in predicting treatment outcomes of diabetic macular edema after ranibizumab injections. Medicina. 2023 Mar 21;59(3):629. https://doi.org/10.3390/medicina59030629

Chou HD, Wu CH, Chiang WY, Chen NN, Hwang YS, Chen KJ, Lai CH, Wu PC, Chen YH, Yeung L, Shao SC. Optical coherence tomography and imaging biomarkers as outcome predictors in diabetic macular edema treated with dexamethasone implant. Scientific Reports. 2022 Mar 9;12(1):3872. https://doi.org/10.1038/s41598-022-07604-7

Panozzo G, Cicinelli MV, Dalla Mura G, Giannarelli D, Vadalà M, Bonfiglio V, Bellisario G, Bandello F. Enhancing diabetic macular edema treatment outcomes: exploring the ESASO classification and structural OCT biomarkers. Ophthalmology and Therapy. 2024 May;13(5):1383-98. https://doi.org/10.1007/s40123-024-00925-y

Maggio E, Mete M, Sartore M, Bauci F, Guerriero M, Polito A, Pertile G. Temporal variation of optical coherence tomography biomarkers as predictors of anti-VEGF treatment outcomes in diabetic macular edema. Graefe's Archive for Clinical and Experimental Ophthalmology. 2022 Mar;260(3):807-15. https://doi.org/10.1007/s00417-021-05387-7

Nanji K, Grad J, Hatamnejad A, El-Sayes A, Mihalache A, Gemae M, Huang R, Phillips M, Kaiser PK, Munk MR, Garg SJ. Baseline Optical Coherence Tomography Biomarkers Associated with Visual Acuity in Diabetic Macular Edema: A Systematic Review and Meta-Analysis. Ophthalmology. 2025 Aug 11. https://doi.org/10.1016/j.ophtha.2025.07.038

Huang H, Jansonius NM, Chen H, Los LI. Hyperreflective dots on OCT as a predictor of treatment outcome in diabetic macular edema: a systematic review. Ophthalmology Retina. 2022 Sep 1;6(9):814-27. https://doi.org/10.1016/j.oret.2022.03.020

Subramanian B, Devishamani C, Raman R, Ratra D. Association of OCT biomarkers and visual impairment in patients with diabetic macular oedema with vitreomacular adhesion. Plos one. 2023 Jul 18;18(7):e0288879. https://doi.org/10.1371/journal.pone.0288879

Costanzo E, Giannini D, De Geronimo D, Fragiotta S, Varano M, Parravano M. Prognostic imaging biomarkers in diabetic macular edema eyes treated with intravitreal dexamethasone implant. Journal of Clinical Medicine. 2023 Feb 6;12(4):1303. https://doi.org/10.3390/jcm12041303

Huang YT, Chang YC, Meng PP, Lin CJ, Lai CT, Hsia NY, Chen HS, Tien PT, Bair H, Lin JM, Chen WL. Optical coherence tomography biomarkers in predicting treatment outcomes of diabetic macular edema after dexamethasone implants". Frontiers in Medicine. 2022 Jun 9;9:852022. https://doi.org/10.3389/fmed.2022.852022

Viggiano P, Vujosevic S, Palumbo F, Grassi MO, Boscia G, Borrelli E, Reibaldi M, Sborgia L, Molfetta T, Evangelista F, Alessio G. Optical coherence tomography biomarkers indicating visual enhancement in diabetic macular edema resolved through anti-VEGF therapy: OCT biomarkers in resolved DME. Photodiagnosis and Photodynamic Therapy. 2024 Apr 1;46:104042. https://doi.org/10.1016/j.pdpdt.2024.104042

Velaga SB, Nittala MG, Alagorie AR, Marram J, Hu ZJ, Wang Z, Ciulla TA, Kapik B, Sadda SR, Ip M. OCT outcomes as biomarkers for disease status, visual function, and prognosis in diabetic macular edema. Canadian Journal of Ophthalmology. 2024 Apr 1;59(2):109-18. https://doi.org/10.1016/j.jcjo.2023.01.012

Viggiano P, Bisceglia G, Bacherini D, Chhablani J, Grassi MO, Boscia G, Borrelli E, Reibaldi M, Evangelista F, Alessio G, Boscia F. Long-term visual outcomes and optical coherence tomography biomarkers in eyes with macular edema secondary to retinal vein occlusion following anti-vascular endothelial growth factor therapy. Retina. 2024 Sep 1;44(9):1572-9. https://doi.org/10.1097/IAE.0000000000004157

Nanji K, Grad J, Hatamnejad A, McKechnie T, Phillips M, Cheung CM, Patel PJ, Marco RD, Borrelli E, Steel DH, Sadda SR. Baseline OCT biomarkers predicting visual outcomes in neovascular age-related macular degeneration: A meta-analysis. Ophthalmology. 2025 Jun 24.

https://doi.org/10.1016/j.ophtha.2025.06.018

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Published

2026-07-21

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Section

Original Research Articles

How to Cite

Retrospective analysis of optical coherence tomography (oct) biomarkers predicting visual outcomes in diabetic macular edema. (2026). SJ Ophthalmology Africa, 3(3), 8. https://doi.org/10.51168/he3qyf55

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