Dril Influences Short-term Visual Outcome after Intravitreal Corticosteroid Injection for Refractory Diabetic Macular Edema

Luís, Maria Elisa; Sampaio, Filipa; Costa, José Ferreira; Cabral, Diogo; Teixeira, Carla; Ferreira, Joana

doi:10.1080/02713683.2021.1878540

Cited by 10 publications

(4 citation statements)

References 50 publications

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“…This agreed with Ilkay Kilic Muftuoglu, et al study that found that there are multiple factors that may affect the visual outcomes such as inner retinal layers disorganization or developpment of ischemic maculopathy after DME resolution [12]. Also agreed with M. Luís, et al study that found that DRIL was related to the baseline BCVA and also affect both CMT and BCVA end results [13]. In our study there was no significant changes in FAZ changes were nonstatistically significant during all period of follow-up.…”

Section: Discussionsupporting

confidence: 86%

Optical Coherence Tomography Angiography After Ranibizumab Treatment for Diabetic Macular Edema

Ali

Elagouz

Kh.

et al. 2023

Egyptian Journal of Clinical Ophthalmology

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Purpose: of this study is to assess changes and to assess ischemia that may occur post. Injection using OCT and OCTA and its relation with BCVA. Methods: prospective, observational, cohort study with a total 49 eyes were enrolled in the study to evaluate changes in central macular thickness, visual acuity, foveal avascular zone and vascular density following intravitreal injection of ranibizumab used in patients diagnosed with central involving diabetic macular edema. Results: There was highly significant improvement in BCVA (p <0.0001). As regard macular thickness there was significant reduction of macular thickness (p<0.0001). There is high relation between IS-OS integrity, DRIL and BCVA. We found improvement of IS-OS line post. Injection as regard FAZ there was non-significant enlargement of FAZ post. Injection (p =0.16). Vascular density in superficial capillary plexus was statistically highly significant (decreased) when we compare before and after injection as a whole density, fovea, parafovea &perifovea while it is not significant changes when we compare values between (1&6 m) and between (3&6m). While vascular density in deep capillary plexus It was statistically significant (reduction) only in fovea and perifoveal superior (p= 0.02) while non-statistically significant reduction of vascular density elsewhere. Conclusion:Our result concluded that intravitreal injection of ranibizumab is an influential treatment for diabetic macular edema with minimal ischemia and minimal effect on macular perfusion. Anatomical and functional factors other than central macular thickness are also related to best corrected visual acuity. So, OCT and OCTA are very helpful during follow -up cases with DME to assess macular thickness, inner and outer retinal integrity, degree of macular ischemia and any complication as ERM that may result from injection.

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Section: Discussionsupporting

confidence: 86%

Optical Coherence Tomography Angiography After Ranibizumab Treatment for Diabetic Macular Edema

Ali

Elagouz

Kh.

et al. 2023

Egyptian Journal of Clinical Ophthalmology

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“…Then, neuron cells function and integrity may also be involved, without any restoration possibility. Studies investigating DRIL after a dexamethasone implant for DME found a significant improvement in DRIL after treatment, possibly related to a positive architectural effect on Müller cells [14,32].…”

Section: Discussionmentioning

confidence: 98%

The Disorganization of Retinal Inner Layers Is Correlated to Müller Cells Impairment in Diabetic Macular Edema: An Imaging and Omics Study

Midena

Torresin

Schiavon

et al. 2023

IJMS

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The disorganization of retinal inner layers (DRIL) is an optical coherence tomography (OCT) biomarker strictly associated with visual outcomes in patients with diabetic macular edema (DME) whose pathophysiology is still unclear. The aim of this study was to characterize in vivo, using retinal imaging and liquid biopsy, DRIL in eyes with DME. This was an observational cross-sectional study. Patients affected by center-involved DME were enrolled. All patients underwent spectral domain optical coherence tomography (SD-OCT) and proteomic analysis of aqueous humor (AH). The presence of DRIL at OCT was analyzed by two masked retinal experts. Fifty-seven biochemical biomarkers were analyzed from AH samples. Nineteen eyes of nineteen DME patients were enrolled. DRIL was present in 10 patients (52.63%). No statistically significant difference was found between DME eyes with and without DRIL, considering the AH concentration of all the analyzed biomarkers except for glial fibrillary acidic protein (GFAP), a biomarker of Müller cells dysfunction (p = 0.02). In conclusion, DRIL, in DME eyes, seems to strictly depend on a major dysfunction of Müller cells, explaining its role not only as imaging biomarker, but also as visual function Müller cells-related parameter.

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“…Studies have already shown that DME patients with DRILs have lower retinal function [29]. Luís et al also report in their study published in 2021 that DRILs are a factor that significantly affects clinical and imaging outcomes in refractory DME with intravitreal steroid therapy [30]. However, assessment of DRILs revealed only a low level of reliability.…”

Section: Discussionmentioning

confidence: 99%

Impact of Pachychoroid and DRIL on the Treatment of Diabetic Macular Oedema with Intravitreal Bevacizumab

Gabriel,

Aljundi,

Munteanu

et al. 2024

Klin Monbl Augenheilkd

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Purpose To evaluate the long-term outcome of intravitreal bevacizumab in eyes with diabetic macular oedema (DME) following a PRN (pro re nata) regimen. Additionally, we investigated the effect of the presence of disorganisation of the retinal inner layers (DRILs) and pachychoroid (PC) at baseline on clinical outcome. Methods This retrospective study included 112 naïve eyes with DME that were followed up for 2 years. All eyes were treated with six initial bevacizumab injections at monthly intervals and then received treatment according to a PRN regimen. In case of poor response to bevacizumab, therapy was switched to other agents. Main outcome measures included: best-corrected visual acuity (BCVA), central macular thickness (CMT), and number of intravitreal injections (IVI s). In addition, we examined the effect of the presence of DRILs and PC at baseline on clinical outcome. Results BVCA improved significantly and CMT decreased significantly during the first 2 years of treatment. The number of IVI s per eye was 11.1 ± 4.8 at the end of the second year. Treatment had to be switched to other agents in 47 eyes (42%). The timing of switching was 12.4 ± 6.1 months after a mean of 9.2 ± 3.3 IVI s. Patients with DRILs at baseline (29.5%) had significantly worse BCVA at all time points before and after treatment, although CMT was significantly lower before treatment and comparable to patients without DRILs during treatment. Patients with PC at baseline (35.7%) had no significant differences in BVCA and CMT at all time points compared with patients without PC. Conclusions This study demonstrates statistically significant functional and anatomical improvement in patients with DME treated with intravitreal bevacizumab after 2 years. However, more than 40% of eyes required a switch in therapy. The presence of DRILs at baseline had a negative effect whereas the presence of PC at baseline had no effect on clinical outcome.

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Dril Influences Short-term Visual Outcome after Intravitreal Corticosteroid Injection for Refractory Diabetic Macular Edema

Cited by 10 publications

References 50 publications

Optical Coherence Tomography Angiography After Ranibizumab Treatment for Diabetic Macular Edema

Optical Coherence Tomography Angiography After Ranibizumab Treatment for Diabetic Macular Edema

The Disorganization of Retinal Inner Layers Is Correlated to Müller Cells Impairment in Diabetic Macular Edema: An Imaging and Omics Study

Impact of Pachychoroid and DRIL on the Treatment of Diabetic Macular Oedema with Intravitreal Bevacizumab

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