Abstract
In this retrospective, multicenter study, we determined the predictive value of imaging biomarkers in diabetic macular edema (DME) outcomes following dexamethasone (DEX) implant(s). Sixty-seven eyes of 47 patients’ best-corrected visual acuity (BCVA) and central foveal thickness (CFT) on optical coherence tomography (OCT) before and after intravitreal DEX implants were evaluated. Baseline imaging biomarkers were graded using fundus photography and OCT, and the predictive value of biomarkers for significant treatment effects at six months was analyzed. Six months after 2.0 ± 0.8 (mean ± SD) DEX implants, 35 (52%) and 16 (24%) eyes had CFT reduction ≥ 10% from baseline and decreased to < 300 µm, respectively. BCVA improved ≥ 3 lines in 15 (22%) and remained stable in 38 (57%) eyes. At six months, eyes with severe intraretinal cyst (IRC), abundant hyperreflective dots (HRD), and moderate or severe hard exudate had a significantly higher chance of CFT reduction ≥ 10%. Eyes with abundant HRD at baseline and those underwent three DEX implants were more likely to achieve CFT < 300 µm. Eyes with DME and severe IRC, abundant HRD, or moderate-to-severe hard exudate at baseline were more likely to show a significant reduction in CFT six months after DEX implant.
Highlights
In this retrospective, multicenter study, we determined the predictive value of imaging biomarkers in diabetic macular edema (DME) outcomes following dexamethasone (DEX) implant(s)
Several baseline imaging characteristics including hard exudate (HE), hyperreflective dots (HRD), and intraretinal cyst (IRC) were found to be predictive of the significant treatment outcomes
Since optical coherence tomography (OCT) is widely available in most clinical settings and is non-invasive, these results provide physicians instant guidance for deciding the individualized treatment options
Summary
Multicenter study, we determined the predictive value of imaging biomarkers in diabetic macular edema (DME) outcomes following dexamethasone (DEX) implant(s). Eyes with DME and severe IRC, abundant HRD, or moderate-to-severe hard exudate at baseline were more likely to show a significant reduction in CFT six months after DEX implant. A post hoc analysis showed that nearly 40% of the eyes resulted in suboptimal best-corrected visual acuity (BCVA) improvement of less than five letters after three months of anti-VEGF treatment[2]. A study showed that after six months of a monthly injection, 32–66% of the treated eyes did not respond to anti-VEGF, resulting in persisting edema and reduced visual acuity (VA)[3]. Our study aimed to evaluate the predictive value of imaging biomarkers for outcomes in Asian DME patients following DEX implants in a real-world, multicenter scenario
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