Ophthalmologica

Original Paper

Early Effects of Dexamethasone Implant on Macular Morphology and Visual Function in Patients with Diabetic Macular Edema

Veritti D.a, b · Sarao V.a, b · Galiazzo F.a · Lanzetta P.a, b

Author affiliations

aDepartment of Medicine-Ophthalmology, University of Udine, and bIstituto Europeo di Microchirurgia Oculare (IEMO), Udine, Italy

Keywords: CorticosteroidDiabetic macular edemaOptical coherence tomography

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Ophthalmologica 2017;238:100-105
https://doi.org/10.1159/000475889

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Article / Publication Details

First-Page Preview
Abstract of Original Paper

Received: January 15, 2017
Accepted: April 19, 2017
Published online: May 31, 2017
Issue release date: August 2017

Number of Print Pages: 6
Number of Figures: 2
Number of Tables: 2

ISSN: 0030-3755 (Print)
eISSN: 1423-0267 (Online)

For additional information: https://www.karger.com/OPH

Abstract

Purpose: To evaluate the early effects of dexamethasone implant in patients with diabetic macular edema (DME). Methods: Eyes with DME were prospectively included in the study. Best-corrected visual acuity (BCVA) measurement, complete ophthalmic evaluation, and spectral-domain optical coherence tomography were performed at baseline and 1, 2, 3, 7, 14, 21, 28, 60, and 90 days after treatment. Results: Twenty-three eyes of 20 patients were included in the study. Mean central retinal thickness (CRT) decreased rapidly after treatment (p < 0.0001, repeated measures ANOVA) from 511 μm at baseline to 469 μm after 1 day (p < 0.05), and 275 μm (p < 0.01) at the end of the follow-up. BCVA gain (p < 0.0001, repeated measures ANOVA) was on average +2 ETDRS letters at day 1 (not significant), +9 letters from day 28 to day 90 (p < 0.01). Conclusion: Intravitreal dexamethasone implant showed an early and fast effect in reducing CRT and improving BCVA in DME patients.

© 2017 S. Karger AG, Basel

References

  1. Dugel PU, Bandello F, Loewenstein A: Dexamethasone intravitreal implant in the treatment of diabetic macular edema. Clin Ophthalmol 2015;9:1321-1335.
  2. Funatsu H, Noma H, Mimura T, Eguchi S, Hori S: Association of vitreous inflammatory factors with diabetic macular edema. Ophthalmology 2009;116:73-79.
  3. Tamura H, Miyamoto K, Kiryu J, Miyahara S, Katsuta H, Hirose F, Musashi K, Yoshimura N: Intravitreal injection of corticosteroid attenuates leukostasis and vascular leakage in experimental diabetic retina. Invest Ophthalmol Vis Sci 2005;46:1440-1444.
  4. Boyer DS, Yoon YH, Belfort R Jr, Bandello F, Maturi RK, Augustin AJ, Li XY, Cui H, Hashad Y, Whitcup SM; Ozurdex® MEAD Study Group: Three-year, randomized, sham-controlled trial of dexamethasone intravitreal implant in patients with diabetic macular edema. Ophthalmology 2014;121:1904-1914.
  5. Sarao V, Veritti D, Boscia F, Lanzetta P: Intravitreal steroids for the treatment of retinal diseases. Scientific World Journal 2014;8:989501.
  6. Das A, McGuire PG, Rangasamy S: Diabetic macular edema: pathophysiology and novel therapeutic targets. Ophthalmology 2015;122:1375-1394.
  7. Joussen AM, Poulaki V, Le ML, Koizumi K, Esser C, Janicki H, Schraermeyer U, Kociok N, Fauser S, Kirchhof B, Kern TS, Adamis AP: A central role for inflammation in the pathogenesis of diabetic retinopathy. FASEB J 2004;18:1450-1452.
  8. Antonetti DA, Lieth E, Barber AJ, Gardner TW: Molecular mechanisms of vascular permeability in diabetic retinopathy. Semin Ophthalmol 1999;14:240-248.
  9. Mori F, Hikichi T, Takahashi J, Nagaoka T, Yoshida A: Dysfunction of active transport of blood-retinal barrier in patients with clinically significant macular edema in type 2 diabetes. Diabetes Care 2002;25:1248-1249.
  10. Pannicke T, Iandiev I, Uckermann O, Biedermann B, Kutzera F, Wiedemann P, Wolburg H, Reichenbach A, Bringmann A: A potassium channel-linked mechanism of glial cell swelling in the postischemic retina. Mol Cell Neurosci 2004;26:493-502.
  11. Pannicke T, Iandiev I, Wurm A, Uckermann O, vom Hagen F, Reichenbach A, Wiedemann P, Hammes HP, Bringmann A: Diabetes alters osmotic swelling characteristics and membrane conductance of glial cells in rat retina. Diabetes 2006;55:633-639.
  12. Iandiev I, Wurm A, Hollborn M, Wiedemann P, Grimm C, Remé CE, Reichenbach A, Pannicke T, Bringmann A: Müller cell response to blue light injury of the rat retina. Invest Ophthalmol Vis Sci 2008;49:3559-3567.
  13. Uckermann O, Kutzera F, Wolf A, Pannicke T, Reichenbach A, Wiedemann P, Wolf S, Bringmann A: The glucocorticoid triamcinolone acetonide inhibits osmotic swelling of retinal glial cells via stimulation of endogenous adenosine signaling. J Pharmacol Exp Ther 2005;315:1036-1045.
  14. Fischer S, Renz D, Schaper W, Karliczek GF: In vitro effects of dexamethasone on hypoxia-induced hyperpermeability and expression of vascular endothelial growth factor. Eur J Pharmacol 2001;411:231-243.
  15. Wilson CA, Berkowitz BA, Sato Y, Ando N, Handa JT, De Juan E Jr: Treatment with intravitreal steroid reduces blood-retinal barrier breakdown due to retinal photocoagulation. Arch Ophthalmol 1992;110:1155-1159.
  16. Yucel OE, Can E, Ozturk HE, Birinci H, Sullu Y: Dexamethasone implant in chronic diabetic macular edema resistant to intravitreal ranibizumab treatment. Ophthalmic Res 2017;57:161-165.
  17. Pacella F, Romano MR, Turchetti P, Tarquini G, Carnovale A, Mollicone A, Mastromatteo A, Pacella E: An eighteen-month follow-up study on the effects of intravitreal dexamethasone implant in diabetic macular edema refractory to anti-VEGF therapy. Int J Ophthalmol 2016;9:1427-1432.
  18. Shah AR, Xi M, Abbey AM, Yonekawa Y, Faia LJ, Hassan TS, Ruby AJ, Wolfe JD: Short-term efficacy of intravitreal dexamethasone implant in vitrectomized eyes with recalcitrant diabetic macular edema and prior anti-VEGF therapy. J Ophthalmic Vis Res 2016;11:183-187.
  19. Chhablani J, Bansal P, Veritti D, Sambhana S, Sarao V, Pichi F, Carrai P, Massaro D, Lembo A, Mansour AM, Banker A, Gupta SR, Hamam R, Lanzetta P: Dexamethasone implant in diabetic macular edema in real-life situations. Eye 2016;30:426-430.
  20. Mastropasqua R, Toto L, Borrelli E, Di Antonio L, De Nicola C, Mastrocola A, Di Nicola M, Carpineto P: Morphology and function over a one-year follow up period after intravitreal dexamethasone implant (Ozurdex) in patients with diabetic macular edema. PLoS One 2015;10:e0145663.
  21. Callanan DG, Loewenstein A, Patel SS, Massin P, Corcóstegui B, Li XY, Jiao J, Hashad Y, Whitcup SM: A multicenter, 12-month randomized study comparing dexamethasone intravitreal implant with ranibizumab in patients with diabetic macular edema. Graefes Arch Clin Exp Ophthalmol 2017;255:463-473.
  22. Matonti F, Guigou S, Pommier S, Meyer F, Hajjar C, Merite PY, Parrat E, Rouhette H, Rebollo O, Soler V: Dexamethasone implants in patients with naive diabetic macular edema. Ophthalmologica 2016;235:244.
  23. Zhioua I, Semoun O, Lalloum F, Souied EH: Intravitreal dexamethasone implant in patients with ranibizumab persistent diabetic macular edema. Retina 2015;35:1429-1435.
  24. Sarao V, Veritti D, Furino C, Giancipoli E, Alessio G, Boscia F, Lanzetta P: Dexamethasone implant with fixed or individualized regimen in the treatment of diabetic macular edema: six-month outcomes of the UDBASA study. Acta Ophthalmol 2017, Epub ahead of print.
  25. Bansal P, Gupta V, Gupta A, Dogra MR, Ram J: Efficacy of Ozurdex implant in recalcitrant diabetic macular edema - a single-center experience. Int Ophthalmol 2016;36:207-216.
  26. Esen E, Sizmaz S, Demircan N: Efficacy of dexamethasone intravitreal implant for the treatment of persistent diffuse diabetic macular edema. Int Ophthalmol 2017;37:1-6.
  27. Zucchiatti I, Lattanzio R, Querques G, Querques L, Del Turco C, Cascavilla ML, Bandello F: Intravitreal dexamethasone implant in patients with persistent diabetic macular edema. Ophthalmologica 2012;228:117-122.
  28. Pacella F, Ferraresi AF, Turchetti P, Lenzi T, Giustolisi R, Bottone A, Fameli V, Romano MR, Pacella E: Intravitreal injection of Ozurdex(®) implant in patients with persistent diabetic macular edema, with six-month follow-up. Ophthalmol Eye Dis 2016;8:11-16.
  29. Brucklacher RM, Patel KM, VanGuilder HD, Bixler GV, Barber AJ, Antonetti DA, Lin CM, LaNoue KF, Gardner TW, Bronson SK, Freeman WM: Whole genome assessment of the retinal response to diabetes reveals a progressive neurovascular inflammatory response. BMC Med Genomics 2008;1:26.
  30. Zhao M, Bousquet E, Valamanesh F, Farman N, Jeanny JC, Jaisser F, Behar-Cohen FF: Differential regulations of AQP4 and Kir4.1 by triamcinolone acetonide and dexamethasone in the healthy and inflamed retina. Invest Ophthalmol Vis Sci 2011;52:6340-6347.
  31. Vujosevic S, Bini S, Midena G, Berton M, Pilotto E, Midena E: Hyperreflective intraretinal spots in diabetics without and with nonproliferative diabetic retinopathy: an in vivo study using spectral domain OCT. J Diabetes Res 2013;2013:491835.
  32. Bolz M, Schmidt-Erfurth U, Deak G, Mylonas G, Kriechbaum K, Scholda C; Diabetic Retinopathy Research Group Vienna: Optical coherence tomographic hyperreflective foci: a morphologic sign of lipid extravasation in diabetic macular edema. Ophthalmology 2009;116:914-920.

Article / Publication Details

First-Page Preview
Abstract of Original Paper

Received: January 15, 2017
Accepted: April 19, 2017
Published online: May 31, 2017
Issue release date: August 2017

Number of Print Pages: 6
Number of Figures: 2
Number of Tables: 2

ISSN: 0030-3755 (Print)
eISSN: 1423-0267 (Online)

For additional information: https://www.karger.com/OPH

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Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
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2017, Vol.238, No. 1-2

August 2017

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