Ischemic index changes in diabetic retinopathy after intravitreal dexamethasone implant using ultra wide-field fluorescein angiography: a pilot study

Abstract

Purpose : To investigate the effect dexamethasone intravitreal implant on peripheral ischemia in patients affected by diabetic macular edema (DME).

Methods : Patients with treatment naïve diabetic retinopathy undergoing intravitreal dexamethasone implant for diabetic macular edema (DME) between October 2015 and July 2016. Patients underwent a comprehensive ocular examination at baseline (< 2 weeks before treatment) and 10 ± 2 weeks after dexamethasone implant including best corrected visual acuity (BCVA), intraocular pressure (IOP), optical coherence tomography (OCT), ultra-widefield (UWF) retinography and UWF fluorescein angiography.

Results : Five eyes of three consecutive patients (all males; mean age 73.3 ± 10.1 years) with type 2 DM were enrolled. Mean duration of DR was 6.9 ± 3.9 years. Mean interval between UWFA acquisition was 12.1 ± 2.1 weeks and the mean interval between intravitreal injection and UWFA acquisition was 11.0 ± 1.6 weeks. Mean pre- and post-injection BCVA was 0.37 ± 0.21 logMAR and 0.29 ± 0.09 logMAR, respectively. Mean pre- and post-injection CMT was 457.8 ± 123.4 μm and 388.4 ± 50.3 μm, respectively. Mean pre- and post-injection ISI was 37.5 ± 26.2 % and 16.9 ± 12.2 % (2.2 folds reduction), respectively.

Conclusions : Intravitreal dexamethasone implant reduces peripheral retina ischemia in patients with DR.

This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.