Alejandro Fonollosa1,2, Javier Zarranz-Ventura3, Alicia Valverde4, Erika Becerra3, Carolina Bernal-Morales3, Salvador Pastor-Idoate5, Miguel Angel Zapata5. 1. Begiker-Ophthalmology Research Group, Ophthalmology Department, BioCruces Health Research Institute, Cruces Hospital, University of the Basque Country, Bilbao, Vizcaya, Spain. afonollosacalduch@gmail.com. 2. Ophthalmology Department, Hospital Universitario Cruces, plaza de Cruces s/n CP 48903, Cruces-Baracaldo, Vizcaya, Spain. afonollosacalduch@gmail.com. 3. Hospital Clínic de Barcelona, Barcelona, Spain. 4. Hospital Universitario Clínico San Carlos, Madrid, Spain. 5. Hospital Universitario Vall de Hebrón, Barcelona, Spain.
Abstract
PURPOSE: The purpose of this study is to evaluate the predictive capacity of the baseline hyperreflective dots (HRDs) on the functional and anatomical response in patients with diabetic macular edema (DME). Additionally, we assessed the impact of the intravitreal dexamethasone (DEX) implant on the functional and anatomic outcomes. METHODS: Retrospective, multicenter study. The number of HRDs was graded in four different stages: [A] none HRDs; [B] few, 1-10 HRDs; [C] moderate, 11-20 HRDs; and [D] many, ≥ 21 HRDs. For statistical purposes, groups A and B were combined [scarce HRDs (S-HRDs)] and group D was renamed as [abundant HRDs (A-HRDs)]. The primary endpoints were the mean change in best corrected visual acuity (BCVA) and central macular thickness (CMT) according to baseline HRD stage. RESULTS: One hundred eyes from one hundred patients were included in the study. Mean BCVA significantly improved from 52.9 (50.0 to 55.8) letters ETDRS at baseline to 57.2 (54.0 to 60.4) letters at month 6, p = 0.0039. There were no significant differences between the S-HRDs and A-HRD study groups in BCVA. As compared to baseline, CMT reduction was 106.3 (59.8 to 152.7) μm and 94.2 (34.7 to 153.7) μm in S-HRDs and A-HRD groups, respectively (p < 0.0001 each, respectively). Twenty-three (65.7%) and 18 (62.1%) eyes achieved a CMT reduction ≥ 10% in the S-HRD and A-HRD groups, respectively, p = 0.7640. DEX implant significantly reduced the presence of outer nuclear layer (ONL) disruptions (p = 0.0010). CONCLUSIONS: The number of HRDs did not influence either functional or anatomic outcomes. DEX implant significantly decreases the number of eyes with ONL disruptions, which might improve retinal integrity.
PURPOSE: The purpose of this study is to evaluate the predictive capacity of the baseline hyperreflective dots (HRDs) on the functional and anatomical response in patients with diabetic macular edema (DME). Additionally, we assessed the impact of the intravitreal dexamethasone (DEX) implant on the functional and anatomic outcomes. METHODS: Retrospective, multicenter study. The number of HRDs was graded in four different stages: [A] none HRDs; [B] few, 1-10 HRDs; [C] moderate, 11-20 HRDs; and [D] many, ≥ 21 HRDs. For statistical purposes, groups A and B were combined [scarce HRDs (S-HRDs)] and group D was renamed as [abundant HRDs (A-HRDs)]. The primary endpoints were the mean change in best corrected visual acuity (BCVA) and central macular thickness (CMT) according to baseline HRD stage. RESULTS: One hundred eyes from one hundred patients were included in the study. Mean BCVA significantly improved from 52.9 (50.0 to 55.8) letters ETDRS at baseline to 57.2 (54.0 to 60.4) letters at month 6, p = 0.0039. There were no significant differences between the S-HRDs and A-HRD study groups in BCVA. As compared to baseline, CMT reduction was 106.3 (59.8 to 152.7) μm and 94.2 (34.7 to 153.7) μm in S-HRDs and A-HRD groups, respectively (p < 0.0001 each, respectively). Twenty-three (65.7%) and 18 (62.1%) eyes achieved a CMT reduction ≥ 10% in the S-HRD and A-HRD groups, respectively, p = 0.7640. DEX implant significantly reduced the presence of outer nuclear layer (ONL) disruptions (p = 0.0010). CONCLUSIONS: The number of HRDs did not influence either functional or anatomic outcomes. DEX implant significantly decreases the number of eyes with ONL disruptions, which might improve retinal integrity.
Authors: Javier Zarranz-Ventura; Barbara Romero-Núñez; Carolina Bernal-Morales; Daniel Velazquez-Villoria; Anna Sala-Puigdollers; Marc Figueras-Roca; Sergio Copete; Laura Distefano; Anna Boixadera; Jose García-Arumi; Alfredo Adan Journal: BMC Ophthalmol Date: 2020-11-11 Impact factor: 2.209
Authors: Patricia Udaondo; Alfredo Adan; Luis Arias-Barquet; Francisco J Ascaso; Francisco Cabrera-López; Verónica Castro-Navarro; Juan Donate-López; Alfredo García-Layana; Francisco Javier Lavid; Mariano Rodríguez-Maqueda; José María Ruiz-Moreno Journal: Clin Ophthalmol Date: 2021-07-27