Dinah Zur1, Matias Iglicki2, Anna Sala-Puigdollers3, Jay Chhablani4, Marco Lupidi5, Samantha Fraser-Bell6, Thais Sousa Mendes7,8, Voraporn Chaikitmongkol9, Zafer Cebeci10, Dolev Dollberg1, Catharina Busch11, Alessandro Invernizzi12,13, Zohar Habot-Wilner1, Anat Loewenstein1,14. 1. Division of Ophthalmology, Tel Aviv Sourasky Medical Center, Affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. 2. University of Buenos Aires, Buenos Aires, Argentina. 3. Institut Clínic d'Oftalmologia (ICOF), Hospital Clínic de Barcelona, Barcelona, Spain. 4. L.V.Prasad Eye Institute, Banjara Hills, Hyderabad, India. 5. Section of Ophthalmology, Department of Surgical and Biomedical Sciences, S. Maria della Misericordia Hospital, University of Perugia, Perugia, Italy. 6. Department of Ophthalmology, Save Sight Institute, University of Sydney, Sydney, NSW, Australia. 7. RetinaPro Clinic, Belem, Brazil. 8. Department of Ophthalmology, Federal University of Sao Paulo, Sao Paulo, Brazil. 9. Retina Division, Department of Ophthalmology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand. 10. Istanbul Faculty of Medicine, Department of Ophthalmology, Istanbul University, Istanbul, Turkey. 11. Department of Ophthalmology, University of Leipzig, Leipzig, Germany. 12. Eye Clinic - Department of Biomedical and Clinical Science "L. Sacco", Luigi Sacco Hospital, University of Milan, Milan, Italy. 13. Save Sight Institute, University of Sydney, Sydney, NSW, Australia. 14. Incumbent, Sydney A. Fox Chair in Ophthalmology, Tel Aviv University, Tel Aviv, Israel.
Abstract
PURPOSE: To investigate disorganization of retinal inner layers (DRIL) as a biomarker in eyes with diabetic macular oedema (DME) treated by intravitreal dexamethasone (DEX) implant. METHODS: Multicentre, retrospective study including eyes with DME treated with DEX implant and follow-up of 12 months after the first injection. OCT scans were evaluated for the presence of DRIL and other structural features. Best corrected visual acuity (BCVA) and central subfield thickness (CST) were recorded at baseline and at 2, 4, 6 and 12 months after treatment. Correlation between DRIL at baseline and outcomes after DEX treatment and the change in DRIL were analysed. RESULTS: A total of 177 eyes (177 patients; naïve, n = 131; refractory, n = 46) were included. Patients without DRIL at baseline gained significantly more vision and enjoyed greater reduction in CST over 12 months (both p = 0.03). DRIL at the boundary between the ganglion cell-inner plexiform complex and inner nuclear layer improved in 48/64 eyes (75%, p < 0.001), while DRIL between the inner nuclear layer and outer plexiform layer improved in 27/77 eyes (35%, p = 0.004). CONCLUSIONS: This is the first study to show that DEX implant has the potential to ameliorate DRIL. Patients without DRIL at baseline have a favourable outcome. DRIL may serve a robust biomarker in DME treated by DEX implant.
PURPOSE: To investigate disorganization of retinal inner layers (DRIL) as a biomarker in eyes with diabetic macular oedema (DME) treated by intravitreal dexamethasone (DEX) implant. METHODS: Multicentre, retrospective study including eyes with DME treated with DEX implant and follow-up of 12 months after the first injection. OCT scans were evaluated for the presence of DRIL and other structural features. Best corrected visual acuity (BCVA) and central subfield thickness (CST) were recorded at baseline and at 2, 4, 6 and 12 months after treatment. Correlation between DRIL at baseline and outcomes after DEX treatment and the change in DRIL were analysed. RESULTS: A total of 177 eyes (177 patients; naïve, n = 131; refractory, n = 46) were included. Patients without DRIL at baseline gained significantly more vision and enjoyed greater reduction in CST over 12 months (both p = 0.03). DRIL at the boundary between the ganglion cell-inner plexiform complex and inner nuclear layer improved in 48/64 eyes (75%, p < 0.001), while DRIL between the inner nuclear layer and outer plexiform layer improved in 27/77 eyes (35%, p = 0.004). CONCLUSIONS: This is the first study to show that DEX implant has the potential to ameliorate DRIL. Patients without DRIL at baseline have a favourable outcome. DRIL may serve a robust biomarker in DME treated by DEX implant.
Authors: Helena Giannakaki-Zimmermann; Alexandra Behrndt; Laura Hoffmann; Maria-Magdalena Guichard; Cengiz Türksever; Christian Prünte; Katja Hatz Journal: Ophthalmic Res Date: 2021-01-26 Impact factor: 2.892