Effect of Dexamethasone Intravitreal Implant on Visual Acuity and Foveal Photoreceptor Integrity in Macular Edema Secondary to Retinal Vascular Disease

Castro-Navarro, Verónica; Adsuara, Clara Monferrer; Navarro-Palop, Catalina; Montero-Hernández, Javier; Cervera-Taulet, Enrique

doi:10.1159/000512195

Cited by 16 publications

(23 citation statements)

References 51 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Additionally, in eyes with DME refractory to anti-VEGF therapy who received treatment with DEX implant, ORL disruptions might predict smaller VA gains if evaluated after an initial reduction of DME that DEX implant may effectively recover morphology of ORL in DME patients. 93 , 94 …”

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Challenges in Diabetic Macular Edema Management: An Expert Consensus Report

Udaondo

Adán

Arias

et al. 2021

OPTH

Self Cite

View full text Add to dashboard Cite

Purpose: This paper aimed to present daily-practice recommendations for the management of diabetic macular edema (DME) patients based on available scientific evidence and the clinical experience of the consensus panel. Methods: A group of Spanish retina experts agreed to discuss different aspects related with the clinical management of DME patients. Results: Panel was mainly focused on therapeutic objectives in DME management; definition terms; and role of biomarkers as prognostic and predictive factors to intravitreal treatment response. The panel recommends to start DME treatment as soon as possible in those eyes with a visual acuity less than 20/25 (always according to the retina unit capacity). Naïve patient was defined, in a strict manner, as a patient who, up to that moment, had never received any treatment. A refractory DME patient may be defined as the one who did not achieve a complete resolution of the disease, regardless of the treatment administered. Different optical coherence tomography biomarkers, such as disorganization of the retinal inner layers, hyperreflective dots, and cysts, have been identified as prognostic factors. Conclusion:This document has sought to lay down a set of recommendations and to identify key issues that may be useful for the daily management of DME patients.

show abstract

Section: Resultsmentioning

confidence: 99%

“…There is an increasing evidence suggesting that DEX implant may effectively recover the morphology of ORL in DME patients, which might be associated with better functional outcomes. 93 , 94 , 99 , 100 …”

Section: Resultsmentioning

confidence: 99%

Challenges in Diabetic Macular Edema Management: An Expert Consensus Report

Udaondo

Adán

Arias

et al. 2021

OPTH

Self Cite

View full text Add to dashboard Cite

show abstract

“…It should be mentioned that our study did not evaluate the role of OCT biomarkers, which may provide valuable information about the predictive capacity of DEX response. Different OCT biomarkers, such as disorganization of retinal inner layers [ 28 ] or ellipsoid zone integrity [ 29 , 30 ], may predict anatomic and functional outcomes after treatment with DEX implants. This information may be extremely useful, particularly in these times, when the pandemic limits our consultation capacity and it is crucial for optimizing our resources.…”

Section: Discussionmentioning

confidence: 99%

Intravitreal Dexamethasone Implant in Patients Who Did Not Complete Anti-VEGF Loading Dose During the COVID-19 Pandemic: a Retrospective Observational Study

et al. 2021

View full text Add to dashboard Cite

Introduction To compare the functional and anatomic outcomes between eyes in patients with diabetic macular edema (DME) who underwent a complete anti-vascular endothelial growth factor (VEGF) loading dose with aflibercept and those who were switched to dexamethasone intravitreal (DEX) implant after an incomplete anti-VEGF treatment regimen during the coronavirus disease 2019 (COVID-19) pandemic. Methods This was a retrospective and comparative study conducted on patients with DME. Main outcome measures were mean change in best corrected visual acuity (BCVA) and central retinal thickness (CRT) from baseline to month 4. Results Forty-three eyes (23 eyes in the anti-VEGF group and 20 eyes in the DEX group) were included. Mean BCVA significantly improved from 37.7 ± 25.3 and 35.7 ± 22.0 letters at baseline to 45.4 (23.9) (mean adjusted BCVA improvement 7.6 ± 20.8 letters, p = 0.033) and 46.1 ± 26.0 (mean adjusted BCVA improvement 10.6 ± 15.9 letters, p = 0.049) at month 4 in the anti-VEGF and DEX groups, respectively, with no significant differences between study groups (mean adjusted BCVA difference 2.8 letters, 95% CI − 9.4 to 14.9 letters, p = 0.648). There were no statistically significant differences in the proportion of eyes that achieved a BCVA improvement of ≥ 5, ≥ 10, and ≥ 15 letters between groups. CRT was significantly reduced from baseline to month 4 in both DEX (mean adjusted CRT reduction 167.3 ± 148.2 µm, p = 0.012) and anti-VEGF groups (mean adjusted CRT reduction 109.9 ± 181.9 µm, p < 0.001), with no differences between them (mean adjusted CRT difference 56.1 µm, 95% CI − 46.0 to 158.2 µm, p = 0.273). Of 20 eyes in the DEX group, 16 (80.0%) and 9 (45.0%) eyes achieved a CRT reduction of ≥ 20% from baseline at 2 months and at 4 months, respectively. Conclusions Our results seem to suggest that DEX implant can significantly improve both functional and anatomic clinical outcomes in patients who were unable to complete anti-VEGF loading dose during the COVID-19 pandemic.

show abstract

“…[17][18][19][20] Additionally, integrity of external limiting membrane and ellipsoid zone was associated with the final BCVA improvement in patients with DME. 26 Nevertheless, while recognizing the importance of OCT for the clinical management of patients with DME, our study focus on identifying predictive factors beyond OCT.…”

mentioning

confidence: 99%

Impact of Different Clinical Baseline Characteristics on Intravitreal Dexamethasone Implant Ozurdex® Outcomes

Udaondo

Hervás-Ontiveros

Rosemblatt

et al. 2021

OPTH

View full text Add to dashboard Cite

Purpose: To determine the impact of different baseline clinical characteristics on the improvement in best corrected visual acuity (BCVA) in patients with diabetic macular edema (DME) who underwent the intravitreal dexamethasone implant (DEX) Ozurdex ® . Methods: This was a single center retrospective study conducted on patients with DME, either naïve or previously treated, who were treated with one or more DEX and had a followup of at least 6 months. The main outcome measure was the proportion of DEX achieving an improvement ≥15 letters in BCVA. Results:The study analyzed 192 DEX implants administered to 97 eyes (65 patients). Among the 192 DEX analyzed, 57 (29.7%) implants achieved a BCVA improvement ≥15 letters (ETDRS) from baseline, with a mean time for achieving such improvement of 89.2 (39.7) days. Eyes who received an additional DEX and those with a duration of DME < 6 months had a greater probability of achieving a BCVA improvement ≥15 letters (odds-ratio: 2.55, p = 0.0028 and odds-ratio: 1.93, p = 0.0434). The mean (standard deviation) change in BCVA from baseline was 7.5 (14.5) letters, p < 0.0001. The mean change in central macular thickness (CMT) from baseline was −128.0 (151.0) µm, p < 0.0001. The mean number of DEX implanted was 1.9 (0.8). Four (2.1%) DEX experienced an intraocular pressure increased ≥10 mm Hg; all the cases were successfully managed with topical antiglaucoma medication. Conclusion:The results of this study confirmed previous evidence suggesting that DEX is effective for improving BCVA and CMT in patients with DME.

show abstract

Effect of Dexamethasone Intravitreal Implant on Visual Acuity and Foveal Photoreceptor Integrity in Macular Edema Secondary to Retinal Vascular Disease

Cited by 16 publications

References 51 publications

Challenges in Diabetic Macular Edema Management: An Expert Consensus Report

Challenges in Diabetic Macular Edema Management: An Expert Consensus Report

Intravitreal Dexamethasone Implant in Patients Who Did Not Complete Anti-VEGF Loading Dose During the COVID-19 Pandemic: a Retrospective Observational Study

Impact of Different Clinical Baseline Characteristics on Intravitreal Dexamethasone Implant Ozurdex® Outcomes

Contact Info

Product

Resources

About