Osman PARÇA, Ebru Nevin ÇETİN, Gökhan PEKEL
The European Research Journal - 2026;12(9):974-984
Objective: To investigate whether residual optical coherence tomography (OCT) findings in the neurosensory retina and quantitative choroidal parameters are associated with best-corrected visual acuity (BCVA) after center-involved diabetic macular edema (DME) has resolved following anti-vascular endothelial growth factor (anti-VEGF) treatment. Methods: Medical records of 44 patients comprising 49 treated eyes were reviewed retrospectively. All eyes had received at least 3 initial intravitreal anti-VEGF injections before the postresolution assessment. Central 1 mm spectral-domain OCT B-scans were examined for disorganization of the retinal inner layers (DRIL), ellipsoid zone (EZ) disruption, and external limiting membrane (ELM) disruption. Enhanced-depth imaging OCT was used to measure subfoveal choroidal thickness (SFCT) and calculate the choroidal vascularity index (CVI) after Otsu-based binarization of a manually selected subfoveal choroidal area. Generalized estimating equation (GEE) models were used to account for inter-eye correlation. Results: Mean (SD) BCVA was 0.48 (0.45) logMAR. Mean (SD) SFCT and CVI were 241 (60) mum and 0.65 (0.08), respectively. BCVA was poorer in eyes with DRIL (P = .008), ELM disruption (P < .001), and EZ disruption (P = .001). DRIL was also associated with a higher frequency of ELM and EZ disruption (P < .001 and P = .001, respectively). Hard exudates were not significantly associated with BCVA after GEE analysis (P = .055). Choroidal thickness and CVI did not differ significantly across retinal biomarker subgroups. CVI showed a modest inverse association with age (r = -0.324, P = .023) but was not significantly associated with BCVA. Conclusion: In eyes evaluated after resolution of center-involved DME, poorer BCVA was associated with persistent inner and outer retinal microstructural abnormalities, particularly DRIL and ELM/EZ disruption. In contrast, posttreatment SFCT and CVI were not significantly associated with BCVA or retinal biomarker status.
