Progression of Diabetic Retinopathy Severity after Treatment
with Dexamethasone Implant – A 24-Month Cohort Study
The ‘DR-Pro-DEX Study’

Abstract

Purpose : While intravitreal anti-vascular endothelial growth factor agents have recently been shown to reduce progression of diabetic retinopathy (DR), data on the effects of intravitreal corticosteroids on modifying disease severity is limited. This study evaluates the long-term effect of intravitreal dexamethasone implant (DEX) on the severity and progression of non proliferative DR (NPDR).

Methods : This was a retrospective cohort study of patients with NPDR and diabetic macular edema (DME) treated with as required dexamethasone implant (DEX-group) compared to controls without DME requiring observation only with a follow-up of 24 months. Outcome measures included change of DR ≥ 1 grade and progression to proliferative diabetic retinopathy (PDR).

Results : 109 eyes from 109 patients were included: 60 eyes in the DEX-group and 49 control eyes. Three eyes (5%) in the DEX-group, and 43 (87.8%) eyes in the control group progressed to PDR (p< 0.0001). Twenty-five eyes (41.7%) in the DEX group but none in the control group demonstrated an improvement in DR severity (p < 0.0001).

Conclusions : This study provides the first long-term evidence that DEX implant has the potential to not only delay progression of DR and PDR development, but may also improve DR severity over 24 months. Better understanding of the effects of corticosteroids will help guide its use in the treatment pathway of DR.

This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.

 

Fig. 1 Change in severity of diabetic retinopathy (DR) at 24 months follow-up stratified for baseline DR severity. DEX-group – subjects with non-proliferative diabetic retinopathy (NPDR) and diabetic macula edema (DME), treated with dexamethasone implant; Control Group – Subjects with NPDR without DME.

 

FIg. 2 Change in severity of diabetic retinopathy (DR) at 24 months follow-up. DEX-group (n=60) – Patients with non-proliferative diabetic retinopathy (NPDR) and diabetic macula edema (DME), treated with dexamethasone implant, Control (n=49) – Patients with NPDR without DME. Numbers of patients are indicated above each bar.