6533b823fe1ef96bd127f724
RESEARCH PRODUCT
Dexamethasone for unresponsive diabetic macular oedema: optical coherence tomography biomarkers
Andrea RussoAlessandra PizzoGiuseppe FaroVincenza BonfiglioAntonio LongoMichele ReibaldiIacopo MacchiTeresio Avitabilesubject
MaleVisual acuitygenetic structuresVisual AcuityAngiogenesis InhibitorsDrug Implantchemistry.chemical_compound0302 clinical medicineGlucocorticoidMacula LuteaProspective StudiesFluorescein AngiographyProspective cohort studyTomographyDrug Implantsmedicine.diagnostic_testGeneral MedicineDiabetic retinopathyDrug ToleranceFluorescein angiographyTreatment Outcomediabetic macular oedemaIntravitreal InjectionsFemalemedicine.symptomDrugTomography Optical Coherencemedicine.drugAngiogenesis InhibitorHumanmedicine.medical_specialtyFundus Oculibest-corrected visual acuity; dexamethasone; diabetes retinopathy; diabetic macular oedema; optical coherence tomography; ranibizumab; Aged; Angiogenesis Inhibitors; Dexamethasone; Diabetic Retinopathy; Dose-Response Relationship Drug; Drug Implants; Drug Tolerance; Female; Fluorescein Angiography; Follow-Up Studies; Fundus Oculi; Glucocorticoids; Humans; Intravitreal Injections; Macula Lutea; Macular Edema; Male; Prospective Studies; Ranibizumab; Tomography Optical Coherence; Treatment Outcome; Visual AcuitydexamethasoneMacular EdemaFollow-Up StudieDose-Response Relationship03 medical and health sciencesOphthalmologyRanibizumabmedicineHumansMacular edemaGlucocorticoidsDexamethasoneAgedbest-corrected visual acuity; dexamethasone; diabetes retinopathy; diabetic macular oedema; optical coherence tomography; ranibizumab; Aged; Angiogenesis Inhibitors; Dexamethasone; Diabetic Retinopathy; Dose-Response Relationship; Drug; Drug Implants; Drug Tolerance; Female; Fluorescein Angiography; Follow-Up Studies; Fundus Oculi; Glucocorticoids; Humans; Intravitreal Injections; Macula Lutea; Macular Edema; Male; Prospective Studies; Ranibizumab; Tomography; Optical Coherence; Treatment Outcome; Visual Acuityoptical coherence tomographyDiabetic RetinopathyDose-Response Relationship Drugbusiness.industryIntravitreal InjectionRetinalmedicine.diseaseeye diseasesOphthalmologyProspective StudiechemistryOptical Coherence030221 ophthalmology & optometrysense organsRanibizumabbusinessdiabetes retinopathy030217 neurology & neurosurgerybest-corrected visual acuityFollow-Up Studiesdescription
Purpose: To analyse the effects of intravitreal dexamethasone implant (DEX) in patients with diabetic macular oedema (DME) unresponsive to ranibizumab treatment, in relation to the inflammatory optical coherence tomography (OCT) retinal features, subfoveal neuroretinal detachment (SND) and hyperreflective retinal spots (HRS). Methods: Patients with DME poorly responsive to three injections of ranibizumab were treated with DEX. Best-corrected visual acuity (BCVA) and central macula thickness (CMT, measured by Spectralis SD-OCT) were assessed at baseline and at 1, 3, and 6 months. Results: Overall, 44 eyes were included in the study. In the whole group, mean BCVA (baseline 51.5 ± 8.3 letters) increased significantly at 1 month (to 56.9 ± 8.8 letters; Tukey HSD p = 0.017) and was 55.5 ± 8.8 letters at 3 months (Tukey HSD p = 0.128). Central macula thickness (CMT) reduced significantly at 1 and 3 months (417 ± 149 μm and 469 ± 128 μm, respectively, both Tukey HSD p < 0.001 versus baseline). Subgroup analysis showed a significant BCVA increase at 1 month in eyes with SND + HRS (from 51.2 ± 9.2 to 58.2 ± 9.0, p = 0.029), and a trend to BCVA increase in eyes with HRS (from 52.3 ± 6.4 to 56.8 ± 7.9, p = 0.080), with a significant CMT decrease in both groups (p < 0.001). No changes of either parameter were found in eyes without SND and HRS. Conclusion: Spectral domain OCT is useful in identifying some inflammatory features in DME. Among DME eyes ‘poorly responsive’ to ranibizumab, those with SND and HRS responded better to DEX implants than those without these features.
| year | journal | country | edition | language |
|---|---|---|---|---|
| 2019-01-01 |