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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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| Published in: | Graefe's archive for clinical and experimental ophthalmology 2019-11, Vol.257 (11), p.2381-2390 |
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| creator | Fonollosa, Alejandro Zarranz-Ventura, Javier Valverde, Alicia Becerra, Erika Bernal-Morales, Carolina Pastor-Idoate, Salvador Zapata, Miguel Angel |
| description | 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
|
| doi_str_mv | 10.1007/s00417-019-04446-4 |
| format | article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2281110404</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2280219154</sourcerecordid><originalsourceid>FETCH-LOGICAL-c375t-6963fb9d48ac03ea3d47ef2066434db9761267eb790f52581810cac479991f1e3</originalsourceid><addsrcrecordid>eNp9kU2O1DAQhS0EYpqGC7BAltgMi4DLduKY3WjEnzTSsABpdpFjV2iPkrixnRHNcTgAh-BkuMkAEgtWJbm-96pcj5DHwJ4DY-pFYkyCqhjoikkpm0reIRuQoq4U41d3yYYpDlUr-NUJeZDSNSu8qOE-OREga9BMb8i39xGdt9nfILVmb6zPBxoG2puEo5-R7g57jBGHEVfIhZxomGneIfVzjubG54hmpA6_mAnzzqRQZH7aj2bO9PTy6xJL68f3ZzQs2YYJU9FR502P2Vs6GbuMJlJ0OJmX1NBpGcs7zhkjTXlxh4fk3mDGhI9u65Z8fP3qw_nb6uLyzbvzs4vKClXnqtGNGHrtZGssE2iEkwoHzppGCul6rRrgjcJeaTbUvG6hBWaNlUprDQOg2JLT1Xcfw-cFU-4mnyyO5R8YltRx3gIAk-WIW_L0H_Q6LHEu2x0pxkFDfaT4StkYUio37PbRTyYeOmDdMcFuTbArCXa_EuyOoie31ks_ofsj-R1ZAcQKpNKaP2H8O_s_tj8BfNyp7g</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2280219154</pqid></control><display><type>article</type><title>Predictive capacity of baseline hyperreflective dots on the intravitreal dexamethasone implant (Ozurdex®) outcomes in diabetic macular edema: a multicenter study</title><source>Springer Nature:Jisc Collections:Springer Nature Read and Publish 2023-2025: Springer Reading List</source><creator>Fonollosa, Alejandro ; Zarranz-Ventura, Javier ; Valverde, Alicia ; Becerra, Erika ; Bernal-Morales, Carolina ; Pastor-Idoate, Salvador ; Zapata, Miguel Angel</creator><creatorcontrib>Fonollosa, Alejandro ; Zarranz-Ventura, Javier ; Valverde, Alicia ; Becerra, Erika ; Bernal-Morales, Carolina ; Pastor-Idoate, Salvador ; Zapata, Miguel Angel</creatorcontrib><description>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
< 0.0001 each, respectively). Twenty-three (65.7%) and 18 (62.1%) eyes achieved a CMT reduction ≥ 10% in the S-HRD and A-HRD groups, respectively,
p
= 0.7640. DEX implant significantly reduced the presence of outer nuclear layer (ONL) disruptions (
p
= 0.0010).
Conclusions
The number of HRDs did not influence either functional or anatomic outcomes. DEX implant significantly decreases the number of eyes with ONL disruptions, which might improve retinal integrity.</description><identifier>ISSN: 0721-832X</identifier><identifier>EISSN: 1435-702X</identifier><identifier>DOI: 10.1007/s00417-019-04446-4</identifier><identifier>PMID: 31451909</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>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</subject><ispartof>Graefe's archive for clinical and experimental ophthalmology, 2019-11, Vol.257 (11), p.2381-2390</ispartof><rights>Springer-Verlag GmbH Germany, part of Springer Nature 2019</rights><rights>Graefe's Archive for Clinical and Experimental Ophthalmology is a copyright of Springer, (2019). All Rights Reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c375t-6963fb9d48ac03ea3d47ef2066434db9761267eb790f52581810cac479991f1e3</citedby><cites>FETCH-LOGICAL-c375t-6963fb9d48ac03ea3d47ef2066434db9761267eb790f52581810cac479991f1e3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>315,786,790,27957,27958</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31451909$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Fonollosa, Alejandro</creatorcontrib><creatorcontrib>Zarranz-Ventura, Javier</creatorcontrib><creatorcontrib>Valverde, Alicia</creatorcontrib><creatorcontrib>Becerra, Erika</creatorcontrib><creatorcontrib>Bernal-Morales, Carolina</creatorcontrib><creatorcontrib>Pastor-Idoate, Salvador</creatorcontrib><creatorcontrib>Zapata, Miguel Angel</creatorcontrib><title>Predictive capacity of baseline hyperreflective dots on the intravitreal dexamethasone implant (Ozurdex®) outcomes in diabetic macular edema: a multicenter study</title><title>Graefe's archive for clinical and experimental ophthalmology</title><addtitle>Graefes Arch Clin Exp Ophthalmol</addtitle><addtitle>Graefes Arch Clin Exp Ophthalmol</addtitle><description>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
< 0.0001 each, respectively). Twenty-three (65.7%) and 18 (62.1%) eyes achieved a CMT reduction ≥ 10% in the S-HRD and A-HRD groups, respectively,
p
= 0.7640. DEX implant significantly reduced the presence of outer nuclear layer (ONL) disruptions (
p
= 0.0010).
Conclusions
The number of HRDs did not influence either functional or anatomic outcomes. DEX implant significantly decreases the number of eyes with ONL disruptions, which might improve retinal integrity.</description><subject>Acuity</subject><subject>Aged</subject><subject>Dexamethasone</subject><subject>Dexamethasone - administration & dosage</subject><subject>Diabetes</subject><subject>Diabetes mellitus</subject><subject>Diabetic retinopathy</subject><subject>Diabetic Retinopathy - complications</subject><subject>Diabetic Retinopathy - diagnosis</subject><subject>Diabetic Retinopathy - drug therapy</subject><subject>Drug Implants</subject><subject>Edema</subject><subject>Eye</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Glucocorticoids - administration & dosage</subject><subject>Humans</subject><subject>Intravitreal Injections</subject><subject>Macula Lutea - pathology</subject><subject>Macular Edema - diagnosis</subject><subject>Macular Edema - drug therapy</subject><subject>Macular Edema - etiology</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Ophthalmology</subject><subject>Retina</subject><subject>Retinal Disorders</subject><subject>Retrospective Studies</subject><subject>Steroids</subject><subject>Time Factors</subject><subject>Tomography, Optical Coherence - methods</subject><subject>Treatment Outcome</subject><subject>Visual Acuity</subject><issn>0721-832X</issn><issn>1435-702X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><recordid>eNp9kU2O1DAQhS0EYpqGC7BAltgMi4DLduKY3WjEnzTSsABpdpFjV2iPkrixnRHNcTgAh-BkuMkAEgtWJbm-96pcj5DHwJ4DY-pFYkyCqhjoikkpm0reIRuQoq4U41d3yYYpDlUr-NUJeZDSNSu8qOE-OREga9BMb8i39xGdt9nfILVmb6zPBxoG2puEo5-R7g57jBGHEVfIhZxomGneIfVzjubG54hmpA6_mAnzzqRQZH7aj2bO9PTy6xJL68f3ZzQs2YYJU9FR502P2Vs6GbuMJlJ0OJmX1NBpGcs7zhkjTXlxh4fk3mDGhI9u65Z8fP3qw_nb6uLyzbvzs4vKClXnqtGNGHrtZGssE2iEkwoHzppGCul6rRrgjcJeaTbUvG6hBWaNlUprDQOg2JLT1Xcfw-cFU-4mnyyO5R8YltRx3gIAk-WIW_L0H_Q6LHEu2x0pxkFDfaT4StkYUio37PbRTyYeOmDdMcFuTbArCXa_EuyOoie31ks_ofsj-R1ZAcQKpNKaP2H8O_s_tj8BfNyp7g</recordid><startdate>20191101</startdate><enddate>20191101</enddate><creator>Fonollosa, Alejandro</creator><creator>Zarranz-Ventura, Javier</creator><creator>Valverde, Alicia</creator><creator>Becerra, Erika</creator><creator>Bernal-Morales, Carolina</creator><creator>Pastor-Idoate, Salvador</creator><creator>Zapata, Miguel Angel</creator><general>Springer Berlin Heidelberg</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7TK</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope></search><sort><creationdate>20191101</creationdate><title>Predictive capacity of baseline hyperreflective dots on the intravitreal dexamethasone implant (Ozurdex®) outcomes in diabetic macular edema: a multicenter study</title><author>Fonollosa, Alejandro ; Zarranz-Ventura, Javier ; Valverde, Alicia ; Becerra, Erika ; Bernal-Morales, Carolina ; Pastor-Idoate, Salvador ; Zapata, Miguel Angel</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c375t-6963fb9d48ac03ea3d47ef2066434db9761267eb790f52581810cac479991f1e3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Acuity</topic><topic>Aged</topic><topic>Dexamethasone</topic><topic>Dexamethasone - administration & dosage</topic><topic>Diabetes</topic><topic>Diabetes mellitus</topic><topic>Diabetic retinopathy</topic><topic>Diabetic Retinopathy - complications</topic><topic>Diabetic Retinopathy - diagnosis</topic><topic>Diabetic Retinopathy - drug therapy</topic><topic>Drug Implants</topic><topic>Edema</topic><topic>Eye</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Glucocorticoids - administration & dosage</topic><topic>Humans</topic><topic>Intravitreal Injections</topic><topic>Macula Lutea - pathology</topic><topic>Macular Edema - diagnosis</topic><topic>Macular Edema - drug therapy</topic><topic>Macular Edema - etiology</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Ophthalmology</topic><topic>Retina</topic><topic>Retinal Disorders</topic><topic>Retrospective Studies</topic><topic>Steroids</topic><topic>Time Factors</topic><topic>Tomography, Optical Coherence - methods</topic><topic>Treatment Outcome</topic><topic>Visual Acuity</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Fonollosa, Alejandro</creatorcontrib><creatorcontrib>Zarranz-Ventura, Javier</creatorcontrib><creatorcontrib>Valverde, Alicia</creatorcontrib><creatorcontrib>Becerra, Erika</creatorcontrib><creatorcontrib>Bernal-Morales, Carolina</creatorcontrib><creatorcontrib>Pastor-Idoate, Salvador</creatorcontrib><creatorcontrib>Zapata, Miguel Angel</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Neurosciences Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central UK/Ireland</collection><collection>AUTh Library subscriptions: ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>PML(ProQuest Medical Library)</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>MEDLINE - Academic</collection><jtitle>Graefe's archive for clinical and experimental ophthalmology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Fonollosa, Alejandro</au><au>Zarranz-Ventura, Javier</au><au>Valverde, Alicia</au><au>Becerra, Erika</au><au>Bernal-Morales, Carolina</au><au>Pastor-Idoate, Salvador</au><au>Zapata, Miguel Angel</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Predictive capacity of baseline hyperreflective dots on the intravitreal dexamethasone implant (Ozurdex®) outcomes in diabetic macular edema: a multicenter study</atitle><jtitle>Graefe's archive for clinical and experimental ophthalmology</jtitle><stitle>Graefes Arch Clin Exp Ophthalmol</stitle><addtitle>Graefes Arch Clin Exp Ophthalmol</addtitle><date>2019-11-01</date><risdate>2019</risdate><volume>257</volume><issue>11</issue><spage>2381</spage><epage>2390</epage><pages>2381-2390</pages><issn>0721-832X</issn><eissn>1435-702X</eissn><notes>ObjectType-Article-1</notes><notes>SourceType-Scholarly Journals-1</notes><notes>ObjectType-Feature-2</notes><notes>content type line 23</notes><abstract>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
< 0.0001 each, respectively). Twenty-three (65.7%) and 18 (62.1%) eyes achieved a CMT reduction ≥ 10% in the S-HRD and A-HRD groups, respectively,
p
= 0.7640. DEX implant significantly reduced the presence of outer nuclear layer (ONL) disruptions (
p
= 0.0010).
Conclusions
The number of HRDs did not influence either functional or anatomic outcomes. DEX implant significantly decreases the number of eyes with ONL disruptions, which might improve retinal integrity.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>31451909</pmid><doi>10.1007/s00417-019-04446-4</doi><tpages>10</tpages></addata></record> |
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| ispartof | Graefe's archive for clinical and experimental ophthalmology, 2019-11, Vol.257 (11), p.2381-2390 |
| issn | 0721-832X 1435-702X |
| language | eng |
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| source | Springer Nature:Jisc Collections:Springer Nature Read and Publish 2023-2025: Springer Reading List |
| 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 |
| title | Predictive capacity of baseline hyperreflective dots on the intravitreal dexamethasone implant (Ozurdex®) outcomes in diabetic macular edema: a multicenter study |
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