Combined Intravitreal Dexamethasone Implant and Cataract Surgery in Patients with Diabetic Retinopathy: Effect on Retina
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ORIGINAL RESEARCH
Combined Intravitreal Dexamethasone Implant and Cataract Surgery in Patients with Diabetic Retinopathy: Effect on Retinal Morphology and Function Angelo Maria Minnella . Martina Maceroni
. Stefano Maria Picardi .
Giorgio Placidi . Elisa De Siena . Stanislao Rizzo . Benedetto Falsini
Received: August 16, 2020 / Accepted: September 14, 2020 Ó The Author(s) 2020
ABSTRACT Introduction: Cataract surgery can be associated with vision-threatening complications in patients with diabetes. This study aimed to assess the functional and anatomic outcomes of the intravitreal dexamethasone (DEX) implant, administered at the time as cataract surgery, in patients with diabetic retinopathy and diabetic macular edema (DME). Methods: This was a retrospective, observational, and single-center study. The primary endpoint was the mean change in central macular thickness (CMT) from baseline to month 1. Secondary endpoints included mean change in best corrected visual acuity (BCVA) from baseline to month 1 and 3, mean change in CMT from baseline to month 3, the photopic negative response (PhNR) and the b wave of flash full-field electroretinogram from baseline
Digital Features To view digital features for this article go to https://doi.org/10.6084/m9.figshare.12944189. A. M. Minnella M. Maceroni (&) S. M. Picardi G. Placidi E. De Siena S. Rizzo B. Falsini Universita` Cattolica del Sacro Cuore, Rome, Italy e-mail: [email protected] A. M. Minnella M. Maceroni S. M. Picardi G. Placidi E. De Siena S. Rizzo B. Falsini UOC Oftalmologia, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy
to month 1, and the incidence of adverse events. Results: Twenty-four eyes of 21 patients were included in the study. The mean (range) age of patients was 69 (63–87) years and 13 (61.9%) were men. Mean (standard deviation) CMT significantly decreased from 447 (134) lm at baseline to 341 (134) lm at month 1 (mean difference - 106 ± 134 lm, 95% CI - 183.9 to - 28.1 lm; p = 0.0087). BCVA significantly improved from 46 (20) ETDRS letters at baseline to 59 (22) ETDRS letters at month 1 (mean difference 13 ± 21 letters, 95% CI 0.8–25.2 letters; p = 0.0375). Regarding electrophysiology, there was a statistically significant reduction in mean PhNR from 5.24 (1.67) lV at baseline to 3.73 (1.19) lV at month 1 (mean difference - 1.51 ± 0.42 lV, 95% CI - 2.4 to - 0.7 lV, p = 0.0008); whereas b wave amplitude did not change (12.69 ± 6.89 lV at baseline versus 12.29 ± 6.30 lV at month 1; p = 0.8347). Four (16.7%) eyes developed ocular hypertension over the course of follow-up, which was successfully controlled with topical hypotensive medication. Conclusion: Perioperative DEX implant significantly improved both anatomic and functional outcomes in patients with DME who underwent cataract surgery. Keywords: Cataract; macular edema;
Diabetes; Diabetic Diabetic retinopathy;
Adv Ther
Electrophysiology; Macular thickness; Personalized medicine; Visual acuity Key Summary Points Why carry out this study? Co
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