Assessment of Inflammation Biomarkers in Diabetic Macular Edema Treated with Intravitreal Dexamethasone Implant

Vural, Esra; Hazar, Leyla

doi:10.1089/jop.2020.0130

Cited by 6 publications

(4 citation statements)

References 41 publications

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“…As such, real-world studies are complements to clinical trials in generating the evidence base for treatment utilization, optimal patient management, and ensuring continued endorsement of therapeutics by regulators, payers, clinicians, and patients. Another limitation of this study is that known biomarkers of therapy response were not considered, including central macular thickness, subretinal fluid, subfoveal neuroretinal detachment, disorganization of retinal inner layers, hyperreflective foci, and photoreceptor integrity [ 35 , 36 , 37 , 38 , 39 , 40 ]. Certainly, one would expect these features to also be predictive of visual response in this cohort using these analyses.…”

Section: Discussionmentioning

confidence: 99%

Visual and Anatomical Outcomes of a Single Intravitreal Dexamethasone in Diabetic Macular Edema: An 8 Year Real-World Study

Faes

Mishra

Lipkova

et al. 2023

JCM

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Importance: Diabetic macular edema (DME) is a major cause of vision loss in patients with diabetes mellitus. Intravitreal dexamethasone is a treatment option for patients unsuitable for or non-responsive to anti-angiogenic agents. Objective: To quantify visual and anatomical outcomes from an initial intravitreal dexamethasone injection over the expected 6-month period of dexamethasone release by the implant. Design and enrolment: This is a retrospective cohort study using electronic medical records of patients reviewed between 1 January 2012 and 1 April 2022. Setting: A tertiary eye-care center in London, United Kingdom; Moorfields Eye Hospital National Healthcare System Foundation Trust. Participants: The cohort comprised 418 adult patients with DME who received an initial treatment of 700 µg intravitreal dexamethasone in the study period. Of these, 240 patients met the inclusion criteria of ≥2 hospital visits following initial injection (≥1 beyond 6 months) and no previous ocular corticosteroid treatment or missing assessment at baseline. Exposure(s): Intravitreal dexamethasone implant (700 µg). Main Outcome(s) and Measure(s): Probability of a positive visual outcome, defined as ≥5 or ≥10 Early Treatment Diabetic Retinopathy Study (ETDRS)-letter gain after treatment when compared to baseline (Kaplan–Meier models). Results: From the initial intravitreal dexamethasone injection alone, we observed a >75% chance of gaining ≥5 ETDRS letters and >50% chance of gaining ≥10 ETDRS letters within 6 months. There was less than a 50% chance of sustaining either positive visual outcome beyond 4 months. Conclusions and Relevance: Most patients can be expected to have a positive visual outcome following an initial injection of dexamethasone implants that subsides within 4 months. Real-world re-treatment was observed to be delayed until after visual benefits were lost in half of the cohort. Further research will be needed to study the effects of delays in re-treatment.

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Section: Discussionmentioning

confidence: 99%

Visual and Anatomical Outcomes of a Single Intravitreal Dexamethasone in Diabetic Macular Edema: An 8 Year Real-World Study

Faes

Mishra

Lipkova

et al. 2023

JCM

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“…22 In the study of Vural et al, it was concluded that dexamethasone implant responds better than anti-VEGF treatment in DME cases with subretinal uid. 23 The CHAMPLAIN study evaluated 55 vitrectomized eyes with treatment-resistant DME. A single dose of 0,7 mg dexamethasone implant was applied to the patients and they were followed for 26 weeks.…”

Section: Discussionmentioning

confidence: 99%

Evaluation Of The Effectiveness Of Intravitreal Anti-VEGF Injection With Intravitreal Dexamethasone Implant In Patients With Treatment-Resistant Diabetic Macular Edema

Koc

Alpay

Hayri

2022

Preprint

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Purpose: To assess the effectiveness of monthly anti-VEGF therapy with an intravitreal dexamethasone (DEX) implant in patients with diabetic macular edema (DME) whose macular edema persists despite anti-VEGF therapy. Materials and methods: This study included 94 eyes of 94 patients whose diabetic macular edema (Central Macular Thickness (CMT) >300 µm) persisted despite previous injections of 3 doses of anti-VEGF. The patients were followed up at the first, second, third, and six month after intravitreal injection. Best corrected visual acuity (BCVA), central macular thickness (CMT) and intraocular pressure (IOP) change parameters were evaluated. Results: In terms of age, proliferation, and lens status, there was no statistically significant difference between the groups. When CMT, BCVA, and IOP were assessed among the 4 groups at the end of the sixth month, no statistical difference between the groups was found. There was no need for medical intervention despite the statistically significant increase in IOP at the end of the sixth month compared to the third month in the dexamethasone implanted groups. In contrast to the decrease in CMT, which was statistically significant in all 4 groups at the end of the 6th month compared to the 3rd month, the increase in BCVA was not statistically significant in any of the 4 groups at the end of the 6th month. Conclusion: According to the results of our study, there is no superiority between continuing with existing anti-VEGF or switching to dexamethasone implant after 3 doses of anti-VEGF.

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“…They suggested that these HRF are marks of the inflammation process, and they appear as a response to early microglia activation. The next one is subretinal fluid [ 62 ]. It can occur in about 15–30% patients with DME.…”

Section: Therapeutic Concepts In Diabetic Retinopathymentioning

confidence: 99%

The Role of Inflammation and Therapeutic Concepts in Diabetic Retinopathy—A Short Review

Gomułka

Ruta²

2023

IJMS

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Diabetic retinopathy (DR) as a microangiopathy is the most common complication in patients with diabetes mellitus (DM) and remains the leading cause of blindness among adult population. DM in its complicated pathomechanism relates to chronic hyperglycemia, hypoinsulinemia, dyslipidemia and hypertension—all these components in molecular pathways maintain oxidative stress, formation of advanced glycation end-products, microvascular changes, inflammation, and retinal neurodegeneration as one of the key players in diabetes-associated retinal perturbations. In this current review, we discuss the natural history of DR with special emphasis on ongoing inflammation and the key role of vascular endothelial growth factor (VEGF). Additionally, we provide an overview of the principles of diabetic retinopathy treatments, i.e., in laser therapy, anti-VEGF and steroid options.

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Assessment of Inflammation Biomarkers in Diabetic Macular Edema Treated with Intravitreal Dexamethasone Implant

Cited by 6 publications

References 41 publications

Visual and Anatomical Outcomes of a Single Intravitreal Dexamethasone in Diabetic Macular Edema: An 8 Year Real-World Study

Visual and Anatomical Outcomes of a Single Intravitreal Dexamethasone in Diabetic Macular Edema: An 8 Year Real-World Study

Evaluation Of The Effectiveness Of Intravitreal Anti-VEGF Injection With Intravitreal Dexamethasone Implant In Patients With Treatment-Resistant Diabetic Macular Edema

The Role of Inflammation and Therapeutic Concepts in Diabetic Retinopathy—A Short Review

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