July 2019
Volume 60, Issue 9
Free
ARVO Annual Meeting Abstract  |   July 2019
Disorganization of Retinal Inner Layers as a Biomarker in Patients with Diabetic Macular Edema Treated with Dexamethasone Implant
Author Affiliations & Notes
  • Dinah Zur
    Ophthalmology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
    Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Tel Aviv, Israel
  • Matias Iglicki
    University of Buenos Aires, Argentina
  • Anna Sala-Puigdollers
    Institut Clínic d'Oftalmologia (ICOF), Hospital Clínic de Barcelona, Spain
  • Jay Chhablani
    L.V.Prasad Eye Institute, India
  • Marco Lupidi
    Department of Biomedical and Surgical Sciences, Section of Ophthalmology, University of Perugia, Italy
  • Samantha Fraser-Bell
    Department of Ophthalmology, Save Sight Institute, University of Sydney, New South Wales, Australia
  • Thais Sousa Mendes
    RetinaPro Clinic, Brazil
    Department of Ophthalmology, Federal University of Sao Paulo, Brazil
  • Voraporn Chaikitmongkol
    Retina Division, Department of Ophthalmology, Faculty of Medicine,, Chiang Mai University, Thailand
  • Zafer Cebeci
    Istanbul Faculty of Medicine, Department of Ophthalmology, Istanbul University, Turkey
  • Dolev Dollberg
    Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Tel Aviv, Israel
  • Catharina Busch
    Department of Ophthalmology,, University of Leipzig, Germany
  • Alessandro Invernizzi
    Eye Clinic - Department of Biomedical and Clinical Science "L. Sacco", Luigi Sacco Hospital, University of Milan, Italy
  • Zohar Habot-Wilner
    Ophthalmology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
    Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Tel Aviv, Israel
  • Anat Loewenstein
    Ophthalmology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
    Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Tel Aviv, Israel
  • Footnotes
    Commercial Relationships   Dinah Zur, None; Matias Iglicki, None; Anna Sala-Puigdollers, None; Jay Chhablani, None; Marco Lupidi, None; Samantha Fraser-Bell, None; Thais Mendes, None; Voraporn Chaikitmongkol, None; Zafer Cebeci, None; Dolev Dollberg, None; Catharina Busch, None; Alessandro Invernizzi, None; Zohar Habot-Wilner, None; Anat Loewenstein, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science July 2019, Vol.60, 3863. doi:
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      Dinah Zur, Matias Iglicki, Anna Sala-Puigdollers, Jay Chhablani, Marco Lupidi, Samantha Fraser-Bell, Thais Sousa Mendes, Voraporn Chaikitmongkol, Zafer Cebeci, Dolev Dollberg, Catharina Busch, Alessandro Invernizzi, Zohar Habot-Wilner, Anat Loewenstein; Disorganization of Retinal Inner Layers as a Biomarker in Patients with Diabetic Macular Edema Treated with Dexamethasone Implant. Invest. Ophthalmol. Vis. Sci. 2019;60(9):3863.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : Identification and characterization of patients with diabetic macular edema (DME) is important for customizing treatment and optimizing outcome. We investigated disorganization of retinal inner layers (DRIL) as a new optical coherence tomography (OCT) biomarker for DME treated by intravitreal dexamethasone (DEX) implant.

Methods : Design: Multicenter, retrospective, observational cohort study.
Participants: 177 eyes from 177 patients treated with DEX implant for DME (naïve, n=131; refractory, n=46) with a follow up of 12 months after the first injection.
OCT scans previous to DEX implants were evaluated for the presence of DRIL, subretinal fluid, presence of cystoid changes, and inner segment-outer segment (IS-OS) continuity. Best corrected visual acuity (BCVA) and central subfield thickness (CST) were recorded at baseline and at 2, 4, 6 and 12 months after treatment with DEX implants. Correlations between OCT measures and visual and anatomical outcomes were analyzed.
Main outcome measures were the Correlation between DRIL at baseline and functional and anatomical outcomes over 12 months after treatment with DEX implant. Secondary outcome measure was the change of DRIL after treatment with DEX implant.

Results : Patients without DRIL at baseline gained significantly more vision and enjoyed a greater reduction in CST over 12 months compared to patients who presented DRIL (both p=0.03) before treatment with DEX implant. DRIL at the boundary between the ganglion cell-inner plexiform complex and inner nuclear layer improved in 48/64 eyes (75%, p <0.001), while DRIL between the inner nuclear layer and outer plexiform layer improved in 27/77 eyes (35%, p=0.004).

Conclusions : Among eyes with DME, those without DRIL at baseline responded significantly better to DEX implants. This is the first study to show that DEX implant has the potential to not only improve retinal thickness, but also to ameliorate DRIL. This study provides new significant information to the list of biomarkers in the treatment of DME.

This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.

 

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