Correlation between the optical density ratio of subretinal fluid in OCT images and visual outcome in eyes with diabetic MacularEdema.

OBJECTIVE: To assess the correlation between the optical density ratio (ODR) of subretinal fluid (SRF) on optical coherence tomography (OCT) and the visual response in eyes with diabetic macular edema (DME), and to evaluate whether the ODR of SRF in DME patients with serous retinal detachment can serve as a potential biomarker for predicting treatment response. METHODS: A retrospective study was conducted on 101 cases of 120 eyes with diabetic macular edema and serous retinal detachment (SRD) who received intravitreal injection treatment for the first time. Among them, 88 eyes were treated with the anti-VEGF drug Conbercept, and 32 eyes were treated with intravitreal injection of a single Dexamethasone Intravitreal Implant (DEX-I). The subretinal fluid optical density was measured, and ODR was computed via ImageJ software. Eyes were divided into the low ODR group (n = 60) and the high ODR group (n = 60) according to the baseline subretinal fluid ODR value. The therapeutic response to different intravitreal drugs were compared between the two groups, so as to analyzed to assess the correlation between baseline subretinal fluid ODR with visual acuity and conventional OCT indicators in DME patients. RESULTS: Both the low ODR group and the high ODR group showed a significant decrease in the SRF height and Central Macular Thickness after treatment (P < 0.0001). The low ODR group showed asubstantial improvement in BCVA after treatment (P < 0.0001), while the high ODR group showed no significant change after treatment (P = 0.482). CONCLUSION: In DME patients with SRD, patients with a lower baseline subretinal fluid ODR had better visual quality recovery after the anti-VEGF drug or steroid hormone treatment, identifying the optical density in subretinal fluid as a clinically relevant biomarker in diabetic macularedema.