scholarly journals Evaluation of Predictive Factors for Successful Intravitreal Dexamethasone in Pseudophakic Cystoid Macular Edema

2017 ◽  
Vol 2017 ◽  
pp. 1-9 ◽  
Author(s):  
Vinodh Kakkassery ◽  
Tim Schultz ◽  
Marc Ilan Wunderlich ◽  
Marc Schargus ◽  
H. Burkhard Dick ◽  
...  
Keyword(s):  
Macular Edema ◽  
Cystoid Macular Edema ◽  
Decision Rules ◽  
Controlled Study ◽  
Data Sets ◽  
Foveal Thickness ◽  
Central Foveal Thickness ◽  
Clinically Significant ◽  
One Year ◽  
Intravitreal Dexamethasone

Purpose. To determine the efficacy, safety, and predictive outcome factors for intravitreal dexamethasone implant (DEX) in pseudophakic cystoid macular edema (PCME). Methods. Retrospective, interventional, controlled study. Patients included had to have clinically significant PCME and have been treated with the DEX between 2012 and 2015. Charts and one-year data were selected consecutively, and efficacy and safety were abstracted. Visual acuity (VA) and central foveal thickness (CFT) were analysed. Results. Nineteen patient data sets were analysed. After treatment with DEX, mean VA increased significantly by 0.2 logMAR (p=0.034), while the mean CFT was reduced significantly by 162.79 μm (p<0.001). Five patients receiving a combination of DEX/bevacizumab have not experienced a higher mean VA gain or CFT reduction compared to fourteen patients receiving DEX alone. Decision rules, when to combine DEX with bevacizumab, have not been defined before the study. Only posttreatment VA gains in the nonhypertensive subgroup (n=11) were significantly better (p=0.026). Analysis of data from diabetes patients (n=4) versus nondiabetics yielded no significant differences in efficacy. There have been no adverse events within follow-up time. Conclusion. The use of DEX in PCME showed significant improvements in VA and CFT. The VA seems to show greater improvements in patients without hypertension.

scholarly journals Evaluation of Functional Outcomes and OCT-Biomarkers after Intravitreal Dexamethasone Implant for Postoperative Cystoid Macular Edema in Vitrectomized Eyes

2020 ◽  
Vol 2020 ◽  
pp. 1-9 ◽  
Author(s):  
Sigrid Freissinger ◽  
Efstathios Vounotrypidis ◽  
Armin Wolf ◽  
Karsten U. Kortuem ◽  
Mehdi Shajari ◽  
...  
Keyword(s):  
Macular Edema ◽  
Cystoid Macular Edema ◽  
Rhegmatogenous Retinal Detachment ◽  
Subretinal Fluid ◽  
Dexamethasone Implant ◽  
Foveal Thickness ◽  
Central Foveal Thickness ◽  
Corrected Visual Acuity ◽  
Intravitreal Dexamethasone Implant ◽  
Intravitreal Dexamethasone

Purpose. To evaluate the efficacy of dexamethasone implant (DEX) for the treatment of postoperative cystoid macular edema (PCME) in vitrectomized eyes and to investigate visual and morphological OCT predictive factors. Methods. In this retrospective study, eyes with PCME after vitrectomy were treated with at least one DEX injection and were observed over 12 months. Indications for surgery were epiretinal membrane (ERM) or rhegmatogenous retinal detachment (RRD) without macular involvement. Prior treatments, if any, were noted. Best corrected visual acuity (BCVA), central foveal thickness (CFT), and OCT morphology including the presence of intraretinal cysts/fluid or subretinal fluid (IRF/SRF) and ellipsoid zone (EZ) continuity were evaluated. Correlations between OCT measures and visual outcomes were analyzed by the generalized estimating equations procedure. Results. Forty-six eyes with ERM and 15 eyes with RRD were enrolled. The ERM group was more likely to gain BCVA than RRD (odds ratio (OR), 1.168; 95% confidence interval (CI), 1.003–1.360; p=0.046). The absence of SRF (OR, 0.860; 95% CI, 0.743–0.995; p=0.043) was predictive of worse BCVA, whereas the integrity of EZ (OR, 1.094; 95% CI, 0.951–1.257; p=0.209) or naïve status (OR, 0.946; 95% CI, 0.871–1.137, p=0.853) was not. Eyes with a worse baseline BCVA were more likely to gain >1 line after 12 months (OR, 1.485; 95% CI, 1.171–1.884; p=0.001). Conclusion. The efficacy of the treatment of PCME in vitrectomized eyes seems to be affected by baseline BCVA, the absence of SRF, and the indication for surgery. Naïve status appears not to play any significant role in the prediction of BCVA. This trial is registered with DRKS00018955.

scholarly journals Comparison of Intravitreal Dexamethasone Implant and Ranibizumab in Vitrectomized Eyes with Diabetic Macular Edema

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Jia-Kang Wang ◽  
Tzu-Lun Huang ◽  
Pei-Yao Chang ◽  
Wei-Ting Ho ◽  
Yung-Ray Hsu ◽  
...  
Keyword(s):  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Glycosylated Hemoglobin ◽  
Dexamethasone Implant ◽  
Intravitreal Ranibizumab ◽  
Foveal Thickness ◽  
Central Foveal Thickness ◽  
Intravitreal Dexamethasone Implant ◽  
Intravitreal Dexamethasone ◽  
Treatment Number

Purpose. This retrospective study aimed to compare the efficacy of intravitreal ranibizumab (IVR) and intravitreal dexamethasone implant (IDI) for pseudophakic vitrectomized eyes with diabetic macular edema (DME) in a single institution. Methods. Pseudophakic vitrectomized eyes with treatment-naïve center-involved DME were enrolled, with one eye in each patient. They were divided into two groups: one group receiving IDI every 3 to 4 months and another group receiving IVR using 3 monthly plus treat-and-extend injections, all with monthly follow-up for 6 months. Switch of intravitreal drugs or deferred macular laser was not allowed. Primary outcome measures included change in central foveal thickness (CFT) in 1 mm by spectral-domain optical coherence tomography and best-corrected visual acuity (BCVA) at Month 6. Results. Twenty-two eyes were included in the IDI group and 26 eyes in the IVR group. The baseline demographics, glycosylated hemoglobin level, intraocular pressure (IOP), BCVA, and CFT did not significantly differ ( p > 0.05 ). Compared to baseline data, CFT decreased and BCVA improved significantly after either IDI or IVR at Month 6 ( p < 0.05 ). Significantly better mean final BCVA (0.38 logMAR vs. 0.62 logMAR, p = 0.04 ), more mean visual gain (−0.30 logMAR vs. −0.15 logMAR, p = 0.02 ), lower mean final CFT (310.9 μm vs. 384.2 μm, p = 0.04 ), and larger mean CFT decrease (−150.0 μm vs. −60.1 μm, p = 0.03 ) were found in the IDI group compared to those in the IVR group. A smaller mean treatment number (2.6 vs. 5.6, p < 0.001 ) and higher rate of postinjection ocular hypertension requiring topical hypotensive agent therapy (27.3% vs. 0%, p = 0.0002 ) were demonstrated in the IDI group than those in the IVR group. Conclusion. We concluded that IDI and IVR can both effectively treat vitrectomized eyes with DME. Dexamethasone implants had significantly better visual/anatomical improvement, smaller treatment number, and higher rate of elevated IOP after injection than IVR in pseudophakic vitrectomized eyes with DME in a 6-month period.

scholarly journals Effect of Topical Nepafenac on Central Foveal Thickness following Panretinal Photocoagulation in Diabetic Patients

2017 ◽  
Vol 2017 ◽  
pp. 1-5 ◽  
Author(s):  
Nahla B. Abu Hussein ◽  
Ahmed A. Mohalhal ◽  
Dalia A. Ghalwash ◽  
Ahmed A. Abdel-Kader
Keyword(s):  
Visual Acuity ◽  
Macular Edema ◽  
Controlled Study ◽  
Control Group ◽  
Diabetic Patients ◽  
Panretinal Photocoagulation ◽  
Eye Drops ◽  
Foveal Thickness ◽  
Central Foveal Thickness ◽  
Snellen Acuity

Purpose. To evaluate effectiveness of topical nepafenac in reducing macular edema following panretinal photocoagulation (PRP). Design. Prospective randomized double-blinded controlled study. Methods. Sixty eyes of 60 patients having proliferative or severe nonproliferative diabetic retinopathy had PRP. Patients were then divided into two groups: nepafenac group (30 eyes) receiving 1% topical nepafenac eye drops for 6 months and control group (30 eyes) receiving carboxymethylcellulose eye drops for 6 months. Best-corrected visual acuity (BCVA) and macular optical coherence tomography were followed up at 1, 2, 4, and 6 months after PRP. Results. BCVA was significantly better in nepafenac group than in control group at all follow-ups (P<0.01). At 6 months post-PRP, logMAR BCVA was 0.11 ± 0.04 (equivalent to 20/26 Snellen acuity) in the nepafenac group and 0.18 ± 0.08 (equivalent to 20/30 Snellen acuity) in the control group (P<0.01). Central foveal thickness (CFT) increased in both groups from the first month after PRP. Increase in CFT was higher in control group than in nepafenac group throughout follow-up, but the difference became statistically significant only after 4 months. No significant ocular adverse events were reported with topical nepafenac. Conclusion. Topical nepafenac can minimize macular edema and stabilize visual acuity following PRP for diabetic patients.

scholarly journals Latent Diabetic Macular Edema in Chinese Diabetic Retinopathy Patients

2021 ◽  
Vol 8 ◽  
Author(s):  
Xue Bai ◽  
Rui Hua
Keyword(s):  
Diabetic Retinopathy ◽  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Foveal Thickness ◽  
Detection Rates ◽  
Central Foveal Thickness ◽  
Clinically Significant Macular Edema ◽  
Color Fundus Images ◽  
Vitreomacular Interface ◽  
Clinically Significant

Purpose: To compare the detection rates of optical coherence tomography (OCT) and fluorescein angiography (FA) in a diabetic macular edema (DME) and the severity of diabetic retinopathy in both color fundus images (CFI) and FA, and to investigate the predictive factors in macular leakages in FA.Methods: This was a retrospective study, and a total of 132 eyes of 77 patients with diabetic retinopathy were enrolled. Macular OCT, FA, and CFI were reviewed and measured. Central foveal thickness was also measured.Results: The severity of diabetic retinopathy in FA was significantly higher than that in CFI (p &lt; 0.001). OCT detected 26 eyes with DMEs, which included the following: 13 eyes with cystoid macular edemas; 13 eyes with serous retinal detachments; 11 eyes with diffuse retinal thickening; 4 eyes with vitreomacular interface abnormalities. In contrast, 72 out of 132 eyes (54.5%) showed macular leakages in FA, which was significantly higher than that detected by OCT (p &lt; 0.001). Compared with FA, the sensitivity and the specificity of OCT in detecting DMEs were 30.6 and 93.3%, respectively. However, central foveal thickness was not significantly different between the patients with non-clinically significant macular edema (CSME, 253.1 ± 26.95 μm) and slight CSME (270.9 ± 37.11 μm, p = 0.204). The mean central foveal thickness in diabetic macular edema (FA) eyes was 271.8 ± 66.02 μm, which was significantly higher than that (253. ± 25.21 μm) in non-DME (FA) eyes (p = 0.039). The central foveal thickness in DME (FA) eyes was significantly lower than that in eyes with DME (OCT) (p = 0.014). After adjusting for age and sex, a logistic regression analysis showed that the classification of diabetic retinopathy in FA was positively associated with macular leakage in FA (p &lt; 0.001).Conclusions: The severity of diabetic retinopathy is underestimated in CFI compared with that in FA. FA can detect latent DMEs, which appeared normal on OCT. The central foveal thickness is not a sensitive parameter for detecting latent DMEs.

scholarly journals Switch of Intravitreal Therapy for Macular Edema Secondary to Retinal Vein Occlusion from Anti-VEGF to Dexamethasone Implant and Vice Versa

2017 ◽  
Vol 2017 ◽  
pp. 1-7 ◽  
Author(s):  
Amelie Pielen ◽  
Anima Desiree Bühler ◽  
Sonja Ute Heinzelmann ◽  
Daniel Böhringer ◽  
Thomas Ness ◽  
...  
Keyword(s):  
Macular Edema ◽  
Retinal Vein Occlusion ◽  
Dexamethasone Implant ◽  
Intravitreal Therapy ◽  
Foveal Thickness ◽  
Central Foveal Thickness ◽  
Vein Occlusion ◽  
Anti Vegf ◽  
Treatment Naïve ◽  
Intravitreal Dexamethasone

Purpose. To evaluate the anatomical and functional outcome of intravitreal dexamethasone implant for macular edema secondary to central (C) or branch (B) retinal vein occlusion (RVO) in patients with persistent macular edema (ME) refractory to intravitreal antivascular endothelial growth factor (VEGF) treatment compared to treatment naïve patients and to dexamethasone-refractory eyes switched to anti-VEGF. Methods. Retrospective, observational study including 30 eyes previously treated with anti-VEGF (8 CRVO, 22 BRVO, mean age 69 ± 10 yrs), compared to 11 treatment naïve eyes (6 CRVO, 5 BRVO, 73 ± 11 yrs) and compared to dexamethasone nonresponders (2 CRVO, 4 BRVO, 69 ± 12). Outcome parameters were change in best-corrected visual acuity (BCVA) and central foveal thickness (CFT) measured by spectral-domain optical coherence tomography. Results. Mean BCVA improvement after switch to dexamethasone implant was 4 letters (p=0.08), and treatment naïve eyes gained 10 letters (p=0.66), while we noted no change in eyes after switch to anti-VEGF (p=0.74). Median CFT decrease was most pronounced in treatment naïve patients (−437 μm, p=0.002) compared to anti-VEGF refractory eyes (−170 μm, p=0.003) and dexamethasone-refractory eyes (−157, p=0.31). Conclusions. Dexamethasone significantly reduced ME secondary to RVO refractory to anti-VEGF. Functional gain was limited compared to treatment naïve eyes, probably due to worse BCVA and CFT at baseline in treatment naïve eyes.

Intravitreal Dexamethasone Implant for Cystoid Macular Edema and Inflammation after Scleral Buckling

2015 ◽  
Vol 25 (5) ◽  
pp. e98-e100 ◽  
Author(s):  
Vincenza Bonfiglio ◽  
Matteo R. Fallico ◽  
Andrea Russo ◽  
Vittorio De Grande ◽  
Antonio Longo ◽  
...  
Keyword(s):  
Macular Edema ◽  
Cystoid Macular Edema ◽  
Scleral Buckling ◽  
Dexamethasone Implant ◽  
Intravitreal Dexamethasone Implant ◽  
Intravitreal Dexamethasone
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