Long-term follow-up of diabetic macular edema treated with dexamethasone implant: a real-life study
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ORIGINAL ARTICLE
Long‑term follow‑up of diabetic macular edema treated with dexamethasone implant: a real‑life study Thibaud Mathis1,2 · Théo Lereuil1 · Amro Abukashabah1 · Nicolas Voirin3 · Aditya Sudhalkar4,5 · Alper Bilgic4 · Philippe Denis1 · Corinne Dot6,7 · Laurent Kodjikian1,2 Received: 26 April 2020 / Accepted: 17 June 2020 © Springer-Verlag Italia S.r.l., part of Springer Nature 2020
Abstract Aims To evaluate the efficacy and safety of intravitreal dexamethasone implant (DEX-implant) for diabetic macular edema (DME) in real-life practice with an extended follow-up for up to 5 year. Methods This multicentric retrospective study reviewed 227 eyes of 152 patients with DME treated by DEX-implant. Main outcome measures included changes in best corrected visual acuity (BCVA), central macular thickness (CMT), time to retreatment and incidence of adverse effects. Results The mean number of DEX-implant received by patients was 2.6 (± 2.2) with a mean (SD) follow-up of 20.1 (± 15.8) months, median [IQR] 15.8 [7.4–30.1]. The mean time of retreatment was 6.9 months. The mean maximal BCVA gain during follow-up was 12.3 (± 12.7) letters. A gain of ≥ 5, ≥ 10 and ≥ 15 letters from baseline BCVA was obtained for 71.8%, 48.9% and 34.8% of eyes, respectively. A total of 62.6% of eyes presented a significant anatomical response (decrease of CMT ≥ 20%), and DME was resolved (absence of cystoid macular spaces on OCT) in 37% of cases at the end of the followup. A transient increase in intraocular pressure ≥ 25 mmHg occurred in 14.1% of eyes, and cataract surgery was performed for 49.1% of the phakic eyes during the follow-up. Four eyes developed a proliferative diabetic retinopathy. Conclusion This large cohort study showed favorable long-term outcomes when using DEX-implant, which provides substantial long-term benefits in the treatment of DME in real life. Keywords Central macular thickness · Corticosteroids · Dexamethasone implant · Diabetic macular edema · Diabetic retinopathy
Introduction
Thibaud Mathis and Théo Lereuil have contributed equally to this work. This article belongs to the topical collection Eye Complications of Diabetes, managed by Giuseppe Querques
Diabetic macular edema (DME) remains one of the main causes of visual impairment in patients with diabetes mellitus [1]. With a dramatic increase in prevalence of diabetes mellitus throughout the world, it follows that effective therapy is needed to improve and preserve vision [2]. In recent
* Laurent Kodjikian laurent.kodjikian@chu‑lyon.fr
4
Alphavision Augenzentrum, Bremerhaven, Germany
5
MS Sudhalkar Medical Research Foundation, Baroda, India
1
6
Department of Ophthalmology, Desgenettes Military Hospital, Lyon, France
7
French Military Health Service Academy of Val-de-Grâce, Paris, France
Service D’Ophtalmologie, Hôpital Universitaire de La Croix‑Rousse, Hospices Civils de Lyon, Université Lyon 1, 103, Grande Rue de la Croix‑Rousse, 69317 Lyon Cedex 04, France
2
Laboratoire UMR‑CNRS 5510 Matéis, Université Lyon 1, Villeurba
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