American Journal of Ophthalmology
American Journal of Ophthalmology
5 years ago

Early response to intravitreal dexamethasone implant therapy in diabetic macular edema may predict visual outcome

To determine whether early visual acuity response to intravitreal dexamethasone implant therapy in diabetic macular edema (DME) is associated with long-term outcome. Design Retrospective case series Methods Multicenter (eight sites) retrospective review of medical records of eyes with DME treated with 0.7mg intravitreal dexamethasone implant and minimum eighteen-month follow-up. One hundred and two eyes were included. Eyes with vitroretinal interface abnormalities or that had undergone vitrectomy were excluded. Eyes were categorized into three groups based on change in best-corrected visual acuity (BCVA) at three months (logMAR equivalence of <5-letter, 5-9-letter, or ≥10-letter gain). Visual acuity outcomes were determined for each early response group. The relationship between early (three month) and overall change in BCVA was assessed using regression analysis. Results In the study population (102 eyes), <5-, 5-9-, and ≥10-letter BCVA improvements were seen in 44.1%, 18.6%, and 37.3% of eyes, respectively, at three months. Among suboptimal (<5-letter) responders at three months, 6.7% showed ≥10-letter gains at study conclusion compared to 29% in the robust (≥10-letter) early response group (p=0.009). Change in BCVA at three months showed significant positive correlation with overall change in BCVA (coefficient=0.44, p=0.002). Conclusions A similar proportion of eyes demonstrated suboptimal (<5-letter) and robust (≥10-letter) early response to treatment at three months. Eyes with a robust early response demonstrated ≥10-letter long-term gain in BCVA at a significantly higher rate compared to those with poor early response. Early treatment response directly correlated with overall change in BCVA.

Publisher URL: www.sciencedirect.com/science

DOI: S0002939417304270

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