The effect of pofterior hyaloid status on treatment success in diabetic rethinopathy cases

INTRODUCTION AND AIM: The aim of this study was to evaluate the effect of posterior hyaloid (PH) detachment, assessed by optical coherence tomography (OCT), on the treatment response in cases receiving intravitreal injections (IVIs) due to diabetic macular edema (DME). METHODS: Patients diagnosed with DME, who received 3 doses of IVIs with a 4-6 week interval, and were followed up for 12 months with OCT evaluation of the PH, were included in the study. Eyes were divided into two groups: those with PH detachment at baseline (Group 1) and those without detachment (Group 2). Bestcorrected visual acuity (BCVA, LogMAR) and its change, central macular thickness (CMT, µm) and its change were compared at baseline, 3 months (1 month after loading dose), 6 months, and 1 year. RESULTS: A total of 457 eyes of 284 patients with DME, who received 3 doses of intravitreal bevacizumab (IVB), ranibizumab (IVR), or aflibercept (IVA) between January 2012 and January 2022, were included in the study. At baseline, PH detachment was observed in 133 eyes (29.1%), PH was intact in 269 eyes (58.8%), and the evaluation of PH status was not possible in 55 eyes (12.1%). After excluding cases with unassessable PH status, the remaining sample included 399 eyes of 249 patients, of which 132 were female (53%) and 117 were male (47%). The mean age was 63.6±9.1 years, and the mean duration of diabetes was 15.4±7.2 years. When comparing the two groups in terms of anti-VEGF efficacy, no significant difference was observed in BCVA at baseline and 1 year, BCVA change at 1 year, baseline CMT, number of IVIs, and number of visits (p-values provided). However, at 1 year, CMT was significantly lower in eyes with PH detachment (p<0.001). CONCLUSION: In cases treated with IVIs due to DME, the presence of PH detachment at baseline did not significantly affect BCVA change and the number of injections and visits during the first year. However, it positively influenced CMT at 1 year. Keywords: Anti-VEGF, diabetic macular edema, intravitreal injection, posterior hyaloid