On spectral domain OCT, a patient with diabetic macular oedema (DME) is found to have disruption of the ellipsoid zone (EZ) at the fovea in addition to intraretinal fluid. How does EZ disruption affect the prognosis of anti-VEGF treatment for DME?
- A It predicts a poorer visual outcome after treatment ✓
- B It predicts a better visual outcome after treatment
- C It is a good prognostic sign indicating early disease
- D It has no bearing on visual prognosis
Correct answer: A. It predicts a poorer visual outcome after treatment
Explanation
The ellipsoid zone on SD-OCT represents the inner segment/outer segment (IS/OS) junction of photoreceptors. Disruption of the EZ at the fovea indicates photoreceptor loss and is associated with reduced baseline visual acuity and a poorer response to anti-VEGF therapy in DME. Intact EZ correlates with better visual recovery after fluid resolution.
Reference: Khurana Comprehensive Ophthalmology, 7th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.