Hasenin Al-Khersan1, Seenu M Hariprasad2, Jay Chhablani3. 1. Pritzker School of Medicine, The University of Chicago, Chicago, Illinois. 2. Department of Ophthalmology and Visual Sciences, The University of Chicago, Chicago, Illinois. 3. L.V. Prasad Eye Institute, Hyderabad, India. Electronic address: jay.chhablani@gmail.com.
Abstract
PURPOSE: To determine whether early visual acuity response to intravitreal dexamethasone implant therapy in diabetic macular edema (DME) is associated with long-term outcome. DESIGN: Retrospective case series. METHODS: Multicenter (8 sites) retrospective review of medical records of eyes with DME treated with 0.7 mg intravitreal dexamethasone implant and minimum 18-month follow-up. One hundred and two eyes were included. Eyes with vitreoretinal interface abnormalities or that had undergone vitrectomy were excluded. Eyes were categorized into 3 groups based on change in best-corrected visual acuity (BCVA) at 3 months (logMAR equivalence of <5-letter, 5-9-letter, or ≥10-letter gain). Visual acuity outcomes were determined for each early response group. The relationship between early (3-month) and overall change in BCVA was assessed using regression analysis. RESULTS: In the study population (102 eyes), <5-letter, 5- to 9-letter, and ≥10-letter BCVA improvements were seen in 44.1%, 18.6%, and 37.3% of eyes, respectively, at 3 months. Among suboptimal (<5-letter) responders at 3 months, 6.7% showed ≥10-letter gains at study conclusion compared to 29% in the robust (≥10-letter) early response group (P = .009). Change in BCVA at 3 months showed significant positive correlation with overall change in BCVA (coefficient = 0.44, P = .002). CONCLUSIONS: A similar proportion of eyes demonstrated suboptimal (<5-letter) and robust (≥10-letter) early response to treatment at 3 months. Eyes with a robust early response demonstrated ≥10-letter long-term gain in BCVA at a significantly higher rate compared to those with poor early response. Early treatment response directly correlated with overall change in BCVA.
PURPOSE: To determine whether early visual acuity response to intravitreal dexamethasone implant therapy in diabetic macular edema (DME) is associated with long-term outcome. DESIGN: Retrospective case series. METHODS: Multicenter (8 sites) retrospective review of medical records of eyes with DME treated with 0.7 mg intravitreal dexamethasone implant and minimum 18-month follow-up. One hundred and two eyes were included. Eyes with vitreoretinal interface abnormalities or that had undergone vitrectomy were excluded. Eyes were categorized into 3 groups based on change in best-corrected visual acuity (BCVA) at 3 months (logMAR equivalence of <5-letter, 5-9-letter, or ≥10-letter gain). Visual acuity outcomes were determined for each early response group. The relationship between early (3-month) and overall change in BCVA was assessed using regression analysis. RESULTS: In the study population (102 eyes), <5-letter, 5- to 9-letter, and ≥10-letter BCVA improvements were seen in 44.1%, 18.6%, and 37.3% of eyes, respectively, at 3 months. Among suboptimal (<5-letter) responders at 3 months, 6.7% showed ≥10-letter gains at study conclusion compared to 29% in the robust (≥10-letter) early response group (P = .009). Change in BCVA at 3 months showed significant positive correlation with overall change in BCVA (coefficient = 0.44, P = .002). CONCLUSIONS: A similar proportion of eyes demonstrated suboptimal (<5-letter) and robust (≥10-letter) early response to treatment at 3 months. Eyes with a robust early response demonstrated ≥10-letter long-term gain in BCVA at a significantly higher rate compared to those with poor early response. Early treatment response directly correlated with overall change in BCVA.
Authors: Tia J Kowal; Philipp P Prosseda; Ke Ning; Biao Wang; Jorge Alvarado; Brent E Sendayen; Sayena Jabbehdari; W Daniel Stamer; Yang Hu; Yang Sun Journal: Transl Vis Sci Technol Date: 2021-05-03 Impact factor: 3.283
Authors: Chiara M Eandi; Daniele De Geronimo; Daniela Giannini; Maria Sole Polito; Gian Marco Tosi; Giovanni Neri; Yannick Le Mer; Monica Varano; Mariacristina Parravano Journal: Acta Diabetol Date: 2020-02-29 Impact factor: 4.280