Macular vessel density in patients with refractory diabetic macular edema in different stages of nonproliferative diabetic retinopathy.

Background: Macular vessel density can play a significant role in the prognosis of diabetic macular edema (DME). The aims of this study were to investigate macular vessel density using optical coherence tomography angiography (OCTA) in patients with refractory DME across different stages of nonproliferative diabetic retinopathy (NPDR) and explore its relationship with clinical parameters.

Material and methods: This was a cross sectional descriptive analytical study. Diabetic patients diagnosed with NPDR and refractory DME were included. OCTA imaging was performed to quantify vessel densities. Foveal avascular zone (FAZ), central macular thickness (CMT), and best corrected visual acuity (BCVA) were also measured.

Results: Eighty nine eyes from 89 patients, including 53 males (59.6%), with a mean age of 60.17 ± 9.95 years were enrolled. The results revealed no significant differences in vessel densities and FAZ between different DR severity groups (P > 0.05). In addition, no significant correlations were observed between vessel density and CMT or most clinical variables, except for a negative correlation between deep capillary plexus (DCP) vessel density in the foveal region and BCVA (r = -0.246, P = 0.019).

Conclusion: In patients with refractory DME, foveal DCP density was negatively correlated with visual acuity, suggesting its potential as a biomarker for visual prognosis and follow up of patients.