Hatz, Katja; Ebneter, Andreas; Tuerksever, Cengiz; Pruente, Christian; Zinkernagel, Martin (2018). Repeated Dexamethasone Intravitreal Implant for the Treatment of Diabetic Macular Oedema Unresponsive to Anti-VEGF Therapy: Outcome and Predictive SD-OCT Features. Ophthalmologica, 239(4), pp. 205-214. Karger 10.1159/000485852
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Purpose: To investigate dexamethasone intravitreal implant 0.7 mg (DEX implant) for the treatment of diabetic macular oedema (DME) refractory to anti-vascular endothelial growth factor (anti-VEGF) therapy and evaluate predictive factors. Methods: Two-centre retrospective interventional case series, including 40 eyes of 31 patients treated with DEX implant for at least 2 consecutive cycles. Results: Mean ± SD intervals from implantation to recurrence in the first (4.2 ± 1.0 months) and second cycles (4.0 ± 0.9 months) were not significantly different. Best corrected visual acuity improved significantly (p < 0.001) by 7.0 ± 8.4 letters from baseline to month 2, and by 5.1 ± 6.9 letters between the first and second cycles. Central retinal thickness reduction 2 months after implantation was greater after the first (–194 ± 172 µm) than the second cycle (–134 ± 150 µm). Ellipsoid zone-external limiting membrane (EZ-ELM) disruption score decreased from 1.39 ± 1.16 at baseline to 1.24 ± 1.16 (p = 0.0832) after cycle 1 and remained stable 2 months after cycle 2. Eyes with persisting severe EZ-ELM disruption (score >2, n = 10) 2 months after the first DEX implant showed significantly (p = 0.0153) smaller visual acuity (VA) gains than eyes with less severe (score ≤2) EZ-ELM disruption. Conclusion: Repeated intravitreal DEX injections with average intervals of 4 months are valuable in patients with DME refractory to anti-VEGF therapy. Disorganization of outer retinal layers (EZ-ELM) may predict smaller VA gains if evaluated after initial reduction of macular oedema.
Item Type: |
Journal Article (Original Article) |
|---|---|
Division/Institute: |
04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Ophthalmology |
UniBE Contributor: |
Ebneter, Andreas, Zinkernagel, Martin Sebastian |
Subjects: |
600 Technology > 610 Medicine & health |
ISSN: |
0030-3755 |
Publisher: |
Karger |
Language: |
English |
Submitter: |
Andreas Ebneter |
Date Deposited: |
01 Mar 2018 10:07 |
Last Modified: |
02 Mar 2023 23:30 |
Publisher DOI: |
10.1159/000485852 |
PubMed ID: |
29402873 |
BORIS DOI: |
10.7892/boris.111168 |
URI: |
https://boris.unibe.ch/id/eprint/111168 |
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