Intravitreal Dexamethasone in Diabetic Macular Oedema: A Way of Enhancing the Response to Anti-VEGF in Non- or Poor Responders?
Aflibercept
Anti-VEGF
Dexamethasone implant
Diabetic macular oedema
Persistent
Ranibizumab
Resistant
Journal
Ophthalmologica. Journal international d'ophtalmologie. International journal of ophthalmology. Zeitschrift fur Augenheilkunde
ISSN: 1423-0267
Titre abrégé: Ophthalmologica
Pays: Switzerland
ID NLM: 0054655
Informations de publication
Date de publication:
2022
2022
Historique:
received:
16
06
2021
accepted:
12
08
2021
pubmed:
30
9
2021
medline:
5
8
2022
entrez:
29
9
2021
Statut:
ppublish
Résumé
The aim of this study was to describe the outcomes of a switch back to anti-vascular endothelial growth factor (VEGF) in diabetic macular oedema (DME) eyes treated temporarily with a dexamethasone implant (DEXi), after an initial poor response to anti-VEGF. The study involved a case series. Twenty-three eyes of 17 patients were included. All were poorly responsive to anti-VEGF and switched to a DEXi after a mean of 12 anti-VEGF injections. The mean best-corrected visual acuity (BCVA) increased from 0.25 ± 0.19 (decimals) to 0.29 ± 0.20 after switching to the DEXi (p = 0.11). BCVA remained stable (0.31 ± 0.23; p = 0.11) after switching back to anti-VEGF, one month after the last injection. The mean central macular thickness (CMT) decreased significantly from 517.0 ± 128.5 μm to 343.4 ± 118.9 μm (p < 0.001) after switching to the DEXi. In eyes receiving ≥3 anti-VEGF injections during the switch back, the CMT 1 month after the last anti-VEGF injection was significantly decreased compared to the CMT before the switch to the DEXi (mean change of - 95.55 ± 89.82 μm, p = 0.005). Switching back poorly responsive DME eyes to anti-VEGF after temporary DEXi therapy is associated with good anatomical and visual outcomes similar to those obtained with the DEXi, provided that at least 3 anti-VEGF injections are administered. The DEXi might restore retinal sensitivity to anti-VEGF.
Sections du résumé
BACKGROUND AND PURPOSE
OBJECTIVE
The aim of this study was to describe the outcomes of a switch back to anti-vascular endothelial growth factor (VEGF) in diabetic macular oedema (DME) eyes treated temporarily with a dexamethasone implant (DEXi), after an initial poor response to anti-VEGF.
METHODS
METHODS
The study involved a case series.
RESULTS
RESULTS
Twenty-three eyes of 17 patients were included. All were poorly responsive to anti-VEGF and switched to a DEXi after a mean of 12 anti-VEGF injections. The mean best-corrected visual acuity (BCVA) increased from 0.25 ± 0.19 (decimals) to 0.29 ± 0.20 after switching to the DEXi (p = 0.11). BCVA remained stable (0.31 ± 0.23; p = 0.11) after switching back to anti-VEGF, one month after the last injection. The mean central macular thickness (CMT) decreased significantly from 517.0 ± 128.5 μm to 343.4 ± 118.9 μm (p < 0.001) after switching to the DEXi. In eyes receiving ≥3 anti-VEGF injections during the switch back, the CMT 1 month after the last anti-VEGF injection was significantly decreased compared to the CMT before the switch to the DEXi (mean change of - 95.55 ± 89.82 μm, p = 0.005).
CONCLUSION
CONCLUSIONS
Switching back poorly responsive DME eyes to anti-VEGF after temporary DEXi therapy is associated with good anatomical and visual outcomes similar to those obtained with the DEXi, provided that at least 3 anti-VEGF injections are administered. The DEXi might restore retinal sensitivity to anti-VEGF.
Identifiants
pubmed: 34587614
pii: 000519235
doi: 10.1159/000519235
doi:
Substances chimiques
Angiogenesis Inhibitors
0
Vascular Endothelial Growth Factor A
0
Bevacizumab
2S9ZZM9Q9V
Dexamethasone
7S5I7G3JQL
Ranibizumab
ZL1R02VT79
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
350-357Informations de copyright
© 2021 S. Karger AG, Basel.