Thibaud Mathis1,2, Théo Lereuil1, Amro Abukashabah1, Nicolas Voirin3, Aditya Sudhalkar4,5, Alper Bilgic4, Philippe Denis1, Corinne Dot6,7, Laurent Kodjikian8,9. 1. Service D'Ophtalmologie, Hôpital Universitaire de La Croix-Rousse, Hospices Civils de Lyon, Université Lyon 1, 103, Grande Rue de la Croix-Rousse, 69317, Lyon Cedex 04, France. 2. Laboratoire UMR-CNRS 5510 Matéis, Université Lyon 1, Villeurbane, France. 3. EPIMOD, 75 route du Mas Vernon, Dompierre Sur Veyle, France. 4. Alphavision Augenzentrum, Bremerhaven, Germany. 5. MS Sudhalkar Medical Research Foundation, Baroda, India. 6. Department of Ophthalmology, Desgenettes Military Hospital, Lyon, France. 7. French Military Health Service Academy of Val-de-Grâce, Paris, France. 8. Service D'Ophtalmologie, Hôpital Universitaire de La Croix-Rousse, Hospices Civils de Lyon, Université Lyon 1, 103, Grande Rue de la Croix-Rousse, 69317, Lyon Cedex 04, France. laurent.kodjikian@chu-lyon.fr. 9. Laboratoire UMR-CNRS 5510 Matéis, Université Lyon 1, Villeurbane, France. laurent.kodjikian@chu-lyon.fr.
Abstract
AIMS: To evaluate the efficacy and safety of intravitreal dexamethasone implant (DEX-implant) for diabetic macular edema (DME) in real-life practice with an extended follow-up for up to 5 year. METHODS: This multicentric retrospective study reviewed 227 eyes of 152 patients with DME treated by DEX-implant. Main outcome measures included changes in best corrected visual acuity (BCVA), central macular thickness (CMT), time to retreatment and incidence of adverse effects. RESULTS: The mean number of DEX-implant received by patients was 2.6 (± 2.2) with a mean (SD) follow-up of 20.1 (± 15.8) months, median [IQR] 15.8 [7.4-30.1]. The mean time of retreatment was 6.9 months. The mean maximal BCVA gain during follow-up was 12.3 (± 12.7) letters. A gain of ≥ 5, ≥ 10 and ≥ 15 letters from baseline BCVA was obtained for 71.8%, 48.9% and 34.8% of eyes, respectively. A total of 62.6% of eyes presented a significant anatomical response (decrease of CMT ≥ 20%), and DME was resolved (absence of cystoid macular spaces on OCT) in 37% of cases at the end of the follow-up. A transient increase in intraocular pressure ≥ 25 mmHg occurred in 14.1% of eyes, and cataract surgery was performed for 49.1% of the phakic eyes during the follow-up. Four eyes developed a proliferative diabetic retinopathy. CONCLUSION: This large cohort study showed favorable long-term outcomes when using DEX-implant, which provides substantial long-term benefits in the treatment of DME in real life.
AIMS: To evaluate the efficacy and safety of intravitreal dexamethasone implant (DEX-implant) for diabetic macular edema (DME) in real-life practice with an extended follow-up for up to 5 year. METHODS: This multicentric retrospective study reviewed 227 eyes of 152 patients with DME treated by DEX-implant. Main outcome measures included changes in best corrected visual acuity (BCVA), central macular thickness (CMT), time to retreatment and incidence of adverse effects. RESULTS: The mean number of DEX-implant received by patients was 2.6 (± 2.2) with a mean (SD) follow-up of 20.1 (± 15.8) months, median [IQR] 15.8 [7.4-30.1]. The mean time of retreatment was 6.9 months. The mean maximal BCVA gain during follow-up was 12.3 (± 12.7) letters. A gain of ≥ 5, ≥ 10 and ≥ 15 letters from baseline BCVA was obtained for 71.8%, 48.9% and 34.8% of eyes, respectively. A total of 62.6% of eyes presented a significant anatomical response (decrease of CMT ≥ 20%), and DME was resolved (absence of cystoid macular spaces on OCT) in 37% of cases at the end of the follow-up. A transient increase in intraocular pressure ≥ 25 mmHg occurred in 14.1% of eyes, and cataract surgery was performed for 49.1% of the phakic eyes during the follow-up. Four eyes developed a proliferative diabetic retinopathy. CONCLUSION: This large cohort study showed favorable long-term outcomes when using DEX-implant, which provides substantial long-term benefits in the treatment of DME in real life.
Authors: Samantha Fraser-Bell; Lyndell L Lim; Anna Campain; Hemal Mehta; Christine Aroney; Jaclyn Bryant; Ji Li; Godfrey J Quin; Ian L McAllister; Mark C Gillies Journal: Ophthalmology Date: 2016-01-09 Impact factor: 12.079
Authors: Laurent Kodjikian; David Bellocq; Francesco Bandello; Anat Loewenstein; Usha Chakravarthy; Adrian Koh; Albert Augustin; Marc D de Smet; Jay Chhablani; Adnan Tufail; Alfredo García-Layana; Aditya Sudhalkar; Thibaud Mathis Journal: Eur J Ophthalmol Date: 2019-06-26 Impact factor: 2.597
Authors: David M Brown; Ursula Schmidt-Erfurth; Diana V Do; Frank G Holz; David S Boyer; Edoardo Midena; Jeffrey S Heier; Hiroko Terasaki; Peter K Kaiser; Dennis M Marcus; Quan D Nguyen; Glenn J Jaffe; Jason S Slakter; Christian Simader; Yuhwen Soo; Thomas Schmelter; George D Yancopoulos; Neil Stahl; Robert Vitti; Alyson J Berliner; Oliver Zeitz; Carola Metzig; Jean-François Korobelnik Journal: Ophthalmology Date: 2015-07-18 Impact factor: 12.079
Authors: Francisco J Goñi; Keith Barton; José António Dias; Michael Diestelhorst; Julián Garcia-Feijoo; Anton Hommer; Laurent Kodjikian; Massimo Nicolò Journal: Ophthalmol Ther Date: 2022-01-05