Baseline SD-OCT characteristics of diabetic macular oedema patterns can predict morphological features and timing of recurrence in patients treated with dexamethasone intravitreal implants

Acta Diabetol. 2020 Jul;57(7):867-874. doi: 10.1007/s00592-020-01504-w. Epub 2020 Feb 29.

Abstract

Aims: To evaluate the timing and spectral-domain optical coherence tomography (SD-OCT) features of diabetic macular oedema (DME) recurrence according to baseline OCT patterns in patients treated with dexamethasone implant (DEX-I).

Methods: This is a retrospective observational study (72 eyes/65 patients). Best-corrected visual acuity, timing of DME recurrence, and SD-OCT pattern [intraretinal cysts (IRC), IRC plus subretinal fluid (mixed), external limiting membrane (ELM), ellipsoid (IS/OS) layer integrity] were assessed at baseline and monthly until first DME recurrence.

Results: Forty-two (58.3%) and 30 (41.6%) DME eyes had an IRC and mixed DME pattern at baseline, respectively. Twenty-four out of thirty mixed eyes (80%) relapsed without subretinal fluid. At baseline, mixed eyes showed similar changes in ELM and IS/OS (60 and 76.6% of eyes, respectively) versus IRC eyes (42.8 and 80.9% of eyes). After DME recurrence, more mixed eyes at baseline showed ELM and IS/OS changes (63.3 and 86.6%) than IRC eyes (50 and 76.2%). 33.3% of mixed eyes had DME recurrence at ≥ 6 months from first DEX-I implant versus 19% of IRC eyes.

Conclusions: Mixed DME eyes were treated with DEX-I relapse later and more frequently without subretinal fluid than IRC eyes. SD-OCT characteristics of different DME patterns at baseline can predict morphological features and timing of DME recurrence.

Keywords: Baseline characteristics; Dexamethasone implant (DEX-I); Diabetic macular oedema; Intravitreal treatment; Recurrence; Spectral-domain optical coherence tomography.

Publication types

  • Observational Study

MeSH terms

  • Aged
  • Dexamethasone / administration & dosage*
  • Diabetic Retinopathy / diagnosis*
  • Diabetic Retinopathy / drug therapy*
  • Diabetic Retinopathy / pathology
  • Drug Implants / administration & dosage
  • Female
  • Fluorescein Angiography
  • Humans
  • Intravitreal Injections
  • Macular Edema / diagnosis*
  • Macular Edema / drug therapy*
  • Macular Edema / pathology
  • Male
  • Middle Aged
  • Organ Size / drug effects
  • Prognosis
  • Recurrence
  • Retina / diagnostic imaging
  • Retina / drug effects
  • Retina / pathology
  • Retina / physiopathology
  • Retrospective Studies
  • Time Factors
  • Tomography, Optical Coherence / methods*
  • Treatment Outcome
  • Visual Acuity / drug effects

Substances

  • Drug Implants
  • Dexamethasone