Disorganization of retinal inner layers as a biomarker in patients with diabetic macular oedema treated with dexamethasone implant

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.

Integrated bioinformatics analysis of aberrantly-methylated differentially-expressed genes and pathways in age-related macular degeneration

“…Recently, a large GWAS highlighted new genes and pathways involved in the development of AMD, including complement activation, collagen synthesis, lipid metabolism/cholesterol transport, receptor-mediated endocytosis, endodermal cell differentiation, and extracellular matrix organization, indicating that many unknown genetic changes remain to be identified with respect to the initiation and development of AMD [20]. The application of novel drugs in the treatment of macular disease also indicated the complicated change of the micro-environment of the macular in the case of disease [29][30][31]. In this study, we screened novel biomarkers by combining microarray information from RPE-choroid and retinal tissue samples from patients with AMD, as well as peripheral blood samples, by overlapping relevant datasets (GSE29801 and GSE10295) using integrated bioinformatics analysis for available microarray data.…”

Integrated bioinformatics analysis of aberrantly-methylated differentially-expressed genes and pathways in age-related macular degeneration

“…The application of novel drugs in the treatment of macular disease also indicated the complicated change of the micro-environment of the macular in the case of disease [29][30][31]. In this study, we screened novel biomarkers by combining microarray information from RPE-choroid and retinal tissue samples from patients with AMD, as well as peripheral blood samples, by overlapping relevant datasets (GSE29801 and GSE10295) using integrated bioinformatics analysis for available microarray data.…”

Differential response to intravitreal dexamethasone implant in naïve and previously treated diabetic macular edema eyes

“…OCT) or aqueous samples. [43][44][45][46] Likewise, recent studies have been directed to identify those patients who don't respond to anti-VEGF treatment, [47] as well as to determine the synergistic and bene cial effect of IDIs in combination with other treatments. [48,49] Signi cantly fewer IDIs were administered to treatment-naïve eyes than to previously treated eyes and indeed, many more treatmentnaïve eyes received just 1 injection than previously treated eyes.…”