Predictive factors of visual acuity improvement after DME treatment with intravitreal dexamethasone implant (Ozurdex®) in the real world

Session Details

Session Title: Free Paper Session 2: Vascular Diseases & Diabetic Retinopathy I

Session Date/Time: Thursday 07/09/2017 | 09:00-10:30

Paper Time: 09:12

Venue: Room 117

First Author: : M.Jimenez Santos SPAIN

Co Author(s): :    A. Aceval   C. Calvo   J. Donate                       

Abstract Details

Purpose:

The objective of this study is not only to evaluate the real-world use efficacy of one or more dexamethasone intravitreal implants for DME but to investigate the predictive factors related to a better improvement of visual acuity after one year of treatment

Setting:

DME clinic of the Retina Department in Hospital Clinico Madrid

Methods:

Retrospective cohort study. the participants were selected among those who received intravitreal Ozurdex® for the treatment of DME.Best corrected, visual acuity, SD-OCT parameters, intraocular pressure and safety and medical data were collected from the medical charts of patients with at least 12 months of follow-up. ). Retreatment criteria followed a PRN strategy and after 3 months, patients with a loss of five letters in BCVA and/or recurrence/persistence of ME as documented by SD-OCT were retreated.

Results:

A total of 87 patients were enrolled. Hba1c was 9,1 ±1,7%, mean length of diabetes diagnosis was 15,25±9,4 years. 64,7% of the patients were previously treated; 80,4% with iv antiVEGF, 64,7% focal laser and 33,3% were treated with iv triamcinolone. BCVA changed from 60,8 to 69,56 at the end of the follow up, and 27,3% of the patients improved 15 or more letters. IOP pretreatment was 15,77±2,27mHg , 17,63±3,96 mmHg one month after injection and 18,44±3,71 mmHg 3 months after. After a mean of 1,87 injection in 12 months of follow up 16,47% of the patients needed ocular hypotensive eye drops. Mean IOP after was 15,29±2,15 mmHg . No patient had an IOP≥35mmHg Statistical analysis showed a significant effect of the treatment on ETDRS (p<0,001) in month 1 and 3 after the injection and after 1 year of follow up as compared with baseline value. Also a significant effect was found in naïve patients compared to patients who received previous treatment. Unadjusted analyses demonstrated a statistically significant relationship between an improvement of 15 letters or more after treatment with presence of subretinal fluid, absence of DRIL and retinal atrophy (p=0,045, p<0,001, p<0,001)

Conclusions:

Our study demonstrates the efficacy and safety profile of the Ozurdex® implant within a year time frame. It also suggest that chronic and unresponsive to previous treatments DME patients may benefit from switching therapies. The patients who would benefit more of the procedure include those with presence of subretinal fluid,absence of DRIL and atrophy as measured with SD-OCT and naïve patients.

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