Prognostic role of optical coherence tomography after switch to dexamethasone in diabetic macular edema
AbstractAimsTo analyze the visual outcome after early switch to dexamethasone (DEX) in eyes with diabetic macular edema previously treated with ranibizumab (RNB), based on structural spectral-domain optical coherence tomography (SD-OCT) features.MethodsRetrospective study of data from 28 eyes which underwent a loading dose of three monthly RNB injections and were then shifted to DEX implant injection. SD-OCT analysis was performed before switch to DEX (week 12, 12W) according to the presence of integrity of ellipsoid zone (EZ) and external limiting membrane (ELM), disorganization of retinal inner layers (DRIL), and quantity of hyper-reflective spots (HRS). Best-corrected visual acuity (BCVA) changes at different time points after DEX (month 1, 1M; 4 months, 4M; and 12 months, 12M) were compared among groups.ResultsSignificantly better BCVA was achieved at 1M in eyes with intact EZ (84.2 ± 12.3 letters;p = 0.04), with intact ELM (83.2 ± 11.5 letters;p
CONCLUSION: The use of intravitreal dexamethasone implants in patients with refractory retinal diseases is well tolerated and results in consistently improved anatomic outcomes, but the positive anatomic outcomes are not necessarily correlated to improvements in visual function. Patients who are treated earlier in the disease process will had better outcomes. This patient population were refractory to treatment and, therefore, have less-predictable functional outcomes. PMID: 31564342 [PubMed - in process]
Conclusion: In our experience, intravitreal implantation of 0.7 mg dexamethasone is an anatomically, and to a lesser extent functionally effective procedure for radiation maculopathy after stereotactic radiotherapy for posterior uveal melanoma.
ConclusionsThe beneficial effect of an early switch to DEX implant in DME non-responders seen at month 12 was maintained during the second year. A later switch from anti-VEGF to steroids still provided significant improvement. Eyes continued on anti-VEGF over a period of 24 months maintained vision. A quarter of eyes, which had not improved vision at 12 months, exhibited a delayed response to treatment.
Seven years ago, Jason Esterhuizen was in a horrific car crash that destroyed his eyes, plunging him into total darkness. Today, he ’s regained visual perception and more independence, thanks to an experimental device implanted in his brain by researchers at UCLA Health.“Now I can do things that I couldn’t do before,” said Esterhuizen, 30, who moved from his native South Africa to participate in the clinical trial at UCLA. “I can sort the laundry, find my way in lighted hallways without using a cane and cross the street more safely. It’s making my life mu ch easier.”The device...
Condition: Diabetic Macular Edema Interventions: Drug: dexamethasone implant; Drug: Ranibizumab Sponsor: Far Eastern Memorial Hospital Completed
Abstract Purpose: The aim of this study is to compare the efficacy of intravitreal injection of aflibercept and dexamethasone implant in the early treatment period of naive diabetic macular edema (DME) with serous retinal detachment (SRD). Materials and Methods: In this retrospective comparative study, medical records of patients who received treatment for naive DME with SRD and underwent three monthly intravitreal aflibercept (IVA) injections (2 mg) or one intravitreal dexamethasone implant (IDI) injection (0.7 mg) were reviewed. The best corrected visual acuity (BCVA), central macular thickness (CM...
Conclusion: In eyes with DME not previously treated with intravitreal drugs, DEX implants provide meaningful functional and anatomical benefits, and these results are sustained mid-long-term. PMID: 31378087 [PubMed - as supplied by publisher]
ConclusionBoth the groups had the similar visual outcome. However, the superior anatomical result was observed in dexamethasone implant group during this short follow-up.