Region-Specific Retinal and Choroidal Biomarkers Associated with Visual Outcomes After Anti-VEGF Treatment in Center-Involved Diabetic Macular Edema

Yuan Qu,1,2,* Hancong Wan,1,2,* Hao Zhou,1,2 Xujun Jiang,1,2 Xin Shi,1,2 Xindan Xing,1,2 Jin Wei,1,2 Yinchen Shen,1,2 Kun Liu1,2 1Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200080, People’s Republic of China; 2National Clinical Research Center for Eye Diseases; Shanghai Key Laboratory of Ocular Fundus Diseases; Shanghai Engineering Center for Visual Science and Photomedicine; Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Diseases; Shanghai Clinical Research Center for Eye Diseases; Shanghai Key Clinical Specialty, Shanghai, 200080, People’s Republic of China*These authors contributed equally to this workCorrespondence: Yinchen Shen, Email shen_yinchen@163.comObjective: This investigation sought to: (1) characterize anti-vascular endothelial growth factor (VEGF) therapy-induced choroidal structural modifications in center-involved diabetic macular edema (CI-DME) utilizing swept-source optical coherence tomography (SS-OCT) imaging, and (2) assess the predictive capacity of choroidal morphometric indices for visual functional prognosis.Methods and Analysis: This retrospective cohort study encompassed CI-DME patients received intravitreal anti-VEGF injections. Structural parameters, including retinal thickness, choroidal thickness, and choroidal vascularity index (CVI), were measured by SS-OCT pre- and post-treatment. Statistical evaluations included paired t-tests, Wilcoxon tests, Elastic Net regression, sensitivity analyses and prognostic analysis. Subgroup analysis was stratified by baseline characteristics.Results: 58 eyes from 53 CI-DME patients were included. Following a single dose of anti-VEGF injection, logMAR BCVA improved significantly from 0.694 ± 0.342 to 0.614 ± 0.429 (P = 0.0103). Total choroidal volumes within the ETDRS grid decreased by 0.065 mm3 (P = 0.031). Retinal thickness significantly declined in all nine ETDRS subfields (P