Predictive capacity of baseline hyperreflective dots on the intravitreal dexamethasone implant (Ozurdex®) outcomes in diabetic macular edema: a multicenter study

Purpose The purpose of this study is to evaluate the predictive capacity of the baseline hyperreflective dots (HRDs) on the functional and anatomical response in patients with diabetic macular edema (DME). Additionally, we assessed the impact of the intravitreal dexamethasone (DEX) implant on the fu...

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Bibliographic Details
Published in:Graefe's archive for clinical and experimental ophthalmology 2019-11, Vol.257 (11), p.2381-2390
Main Authors: Fonollosa, Alejandro, Zarranz-Ventura, Javier, Valverde, Alicia, Becerra, Erika, Bernal-Morales, Carolina, Pastor-Idoate, Salvador, Zapata, Miguel Angel
Format: Article
Language:English
Subjects:
Acuity
Aged
Dexamethasone
Dexamethasone - administration & dosage
Diabetes
Diabetes mellitus
Diabetic retinopathy
Diabetic Retinopathy - complications
Diabetic Retinopathy - diagnosis
Diabetic Retinopathy - drug therapy
Drug Implants
Edema
Eye
Female
Follow-Up Studies
Glucocorticoids - administration & dosage
Humans
Intravitreal Injections
Macula Lutea - pathology
Macular Edema - diagnosis
Macular Edema - drug therapy
Macular Edema - etiology
Male
Medicine
Medicine & Public Health
Ophthalmology
Retina
Retinal Disorders
Retrospective Studies
Steroids
Time Factors
Tomography, Optical Coherence - methods
Treatment Outcome
Visual Acuity
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Summary:Purpose The purpose of this study is to evaluate the predictive capacity of the baseline hyperreflective dots (HRDs) on the functional and anatomical response in patients with diabetic macular edema (DME). Additionally, we assessed the impact of the intravitreal dexamethasone (DEX) implant on the functional and anatomic outcomes. Methods Retrospective, multicenter study. The number of HRDs was graded in four different stages: [A] none HRDs; [B] few, 1–10 HRDs; [C] moderate, 11–20 HRDs; and [D] many, ≥ 21 HRDs. For statistical purposes, groups A and B were combined [scarce HRDs (S-HRDs)] and group D was renamed as [abundant HRDs (A-HRDs)]. The primary endpoints were the mean change in best corrected visual acuity (BCVA) and central macular thickness (CMT) according to baseline HRD stage. Results One hundred eyes from one hundred patients were included in the study. Mean BCVA significantly improved from 52.9 (50.0 to 55.8) letters ETDRS at baseline to 57.2 (54.0 to 60.4) letters at month 6, p  = 0.0039. There were no significant differences between the S-HRDs and A-HRD study groups in BCVA. As compared to baseline, CMT reduction was 106.3 (59.8 to 152.7) μm and 94.2 (34.7 to 153.7) μm in S-HRDs and A-HRD groups, respectively ( p  
ISSN:0721-832X
1435-702X
DOI:10.1007/s00417-019-04446-4