TY - JOUR
T1 - Combined Intravitreal Dexamethasone Implant and Cataract Surgery in Patients with Diabetic Retinopathy: Effect on Retinal Morphology and Function
AU - Minnella, Angelo Maria
AU - Maceroni, Martina
AU - Picardi, Stefano Maria
AU - Placidi, Giorgio
AU - De Siena, Elisa
AU - Rizzo, Stanislao
AU - Falsini, Benedetto
PY - 2020
Y1 - 2020
N2 - Introduction: Cataract surgery can be associated
with vision-threatening complications in
patients with diabetes. This study aimed to
assess the functional and anatomic outcomes of
the intravitreal dexamethasone (DEX) implant,
administered at the time as cataract surgery, in
patients with diabetic retinopathy and diabetic
macular edema (DME).
Methods: This was a retrospective, observational,
and single-center study. The primary
endpoint was the mean change in central
macular thickness (CMT) from baseline to
month 1. Secondary endpoints included mean
change in best corrected visual acuity (BCVA)
from baseline to month 1 and 3, mean change
in CMT from baseline to month 3, the photopic
negative response (PhNR) and the b wave of
flash full-field electroretinogram from baseline to month 1, and the incidence of adverse
events.
Results: Twenty-four eyes of 21 patients were
included in the study. The mean (range) age of
patients was 69 (63–87) years and 13 (61.9%)
were men. Mean (standard deviation) CMT significantly
decreased from 447 (134) lm at
baseline to 341 (134) lm at month 1 (mean
difference - 106 ± 134 lm, 95% CI - 183.9 to
- 28.1 lm; p = 0.0087). BCVA significantly
improved from 46 (20) ETDRS letters at baseline
to 59 (22) ETDRS letters at month 1 (mean difference
13 ± 21 letters, 95% CI 0.8–25.2 letters;
p = 0.0375). Regarding electrophysiology, there
was a statistically significant reduction in mean
PhNR from 5.24 (1.67) lV at baseline to 3.73
(1.19) lV at month 1 (mean difference
- 1.51 ± 0.42 lV, 95% CI - 2.4 to - 0.7 lV,
p = 0.0008); whereas b wave amplitude did not
change (12.69 ± 6.89 lV at baseline versus
12.29 ± 6.30 lV at month 1; p = 0.8347). Four
(16.7%) eyes developed ocular hypertension
over the course of follow-up, which was successfully
controlled with topical hypotensive
medication.
Conclusion: Perioperative DEX implant significantly
improved both anatomic and functional
outcomes in patients with DME who underwent
cataract surgery.
AB - Introduction: Cataract surgery can be associated
with vision-threatening complications in
patients with diabetes. This study aimed to
assess the functional and anatomic outcomes of
the intravitreal dexamethasone (DEX) implant,
administered at the time as cataract surgery, in
patients with diabetic retinopathy and diabetic
macular edema (DME).
Methods: This was a retrospective, observational,
and single-center study. The primary
endpoint was the mean change in central
macular thickness (CMT) from baseline to
month 1. Secondary endpoints included mean
change in best corrected visual acuity (BCVA)
from baseline to month 1 and 3, mean change
in CMT from baseline to month 3, the photopic
negative response (PhNR) and the b wave of
flash full-field electroretinogram from baseline to month 1, and the incidence of adverse
events.
Results: Twenty-four eyes of 21 patients were
included in the study. The mean (range) age of
patients was 69 (63–87) years and 13 (61.9%)
were men. Mean (standard deviation) CMT significantly
decreased from 447 (134) lm at
baseline to 341 (134) lm at month 1 (mean
difference - 106 ± 134 lm, 95% CI - 183.9 to
- 28.1 lm; p = 0.0087). BCVA significantly
improved from 46 (20) ETDRS letters at baseline
to 59 (22) ETDRS letters at month 1 (mean difference
13 ± 21 letters, 95% CI 0.8–25.2 letters;
p = 0.0375). Regarding electrophysiology, there
was a statistically significant reduction in mean
PhNR from 5.24 (1.67) lV at baseline to 3.73
(1.19) lV at month 1 (mean difference
- 1.51 ± 0.42 lV, 95% CI - 2.4 to - 0.7 lV,
p = 0.0008); whereas b wave amplitude did not
change (12.69 ± 6.89 lV at baseline versus
12.29 ± 6.30 lV at month 1; p = 0.8347). Four
(16.7%) eyes developed ocular hypertension
over the course of follow-up, which was successfully
controlled with topical hypotensive
medication.
Conclusion: Perioperative DEX implant significantly
improved both anatomic and functional
outcomes in patients with DME who underwent
cataract surgery.
KW - cataract, diabetes, diabetic macular edema, diabetic retinopathy, electrophysiology, macular thickness, personalized medicine, visual acuity
KW - cataract, diabetes, diabetic macular edema, diabetic retinopathy, electrophysiology, macular thickness, personalized medicine, visual acuity
UR - http://hdl.handle.net/10807/179982
U2 - 10.1007/s12325-020-01506-8
DO - 10.1007/s12325-020-01506-8
M3 - Article
SN - 0741-238X
VL - 2020
SP - N/A-N/A
JO - Advances in Therapy
JF - Advances in Therapy
ER -