Intravitreal fasudil monotherapy for treatment of refractory diabetic macular edema: A prospective interventional case series.

Diabetic macular edema Diabetic retinopathy Retina Rho-kinase Rétine Rétinopathie diabétique Œdème maculaire diabétique

Journal

Journal francais d'ophtalmologie
ISSN: 1773-0597
Titre abrégé: J Fr Ophtalmol
Pays: France
ID NLM: 7804128

Informations de publication

Date de publication:
22 Aug 2023
Historique:
received: 19 11 2022
accepted: 22 03 2023
medline: 25 8 2023
pubmed: 25 8 2023
entrez: 24 8 2023
Statut: aheadofprint

Résumé

Suboptimal response to conventional treatments in refractory diabetic macular edema (rDME) encourages efforts to identify new therapeutic options. To evaluate the effect of three monthly intravitreal injections of a Rho-associated protein kinase (ROCK) inhibitor (Fasudil, Asahi Kasei Pharma Corporation, Tokyo, Japan) in eyes with rDME. Ten eyes of 10 patients with DME unresponsive to at least six previous intravitreal bevacizumab (IVB) injections were recruited and underwent 3 consecutive monthly intravitreal injection of 0.025mg/0.05mL Fasudil. Best-corrected visual acuity (BCVA) and central macular thickness (CMT) were evaluated as functional and anatomical response indicators, respectively. The mean age was 60.1±5.1 years (range, 53-68). Five cases responded to treatment, two with both anatomical and functional responses (reduction of CMT from 521 to 395 and from 390 to 301 microns and improvement of BCVA from 0.3 to 0.1 LogMAR and 0.6 to 0.4 LogMAR, respectively) and three with only functional improvement (0.7 to 0.4; 0.7 to 0.4; and 0.3 to 0.1 LogMAR). Of note, cases with no significant change in CMT showed morphologic improvement of the retinal microstructure to some extent. No adverse event was observed during the study period. Monotherapy with intravitreal injection of ROCK inhibitors appears to have moderate visual benefits in eyes with DME refractory to IVB. Such effects may be functionally significant without obvious anatomical improvement.

Sections du résumé

BACKGROUND BACKGROUND
Suboptimal response to conventional treatments in refractory diabetic macular edema (rDME) encourages efforts to identify new therapeutic options.
PURPOSE OBJECTIVE
To evaluate the effect of three monthly intravitreal injections of a Rho-associated protein kinase (ROCK) inhibitor (Fasudil, Asahi Kasei Pharma Corporation, Tokyo, Japan) in eyes with rDME.
METHODS METHODS
Ten eyes of 10 patients with DME unresponsive to at least six previous intravitreal bevacizumab (IVB) injections were recruited and underwent 3 consecutive monthly intravitreal injection of 0.025mg/0.05mL Fasudil. Best-corrected visual acuity (BCVA) and central macular thickness (CMT) were evaluated as functional and anatomical response indicators, respectively.
RESULTS RESULTS
The mean age was 60.1±5.1 years (range, 53-68). Five cases responded to treatment, two with both anatomical and functional responses (reduction of CMT from 521 to 395 and from 390 to 301 microns and improvement of BCVA from 0.3 to 0.1 LogMAR and 0.6 to 0.4 LogMAR, respectively) and three with only functional improvement (0.7 to 0.4; 0.7 to 0.4; and 0.3 to 0.1 LogMAR). Of note, cases with no significant change in CMT showed morphologic improvement of the retinal microstructure to some extent. No adverse event was observed during the study period.
CONCLUSION CONCLUSIONS
Monotherapy with intravitreal injection of ROCK inhibitors appears to have moderate visual benefits in eyes with DME refractory to IVB. Such effects may be functionally significant without obvious anatomical improvement.

Identifiants

DOI: 10.1016/j.jfo.2023.03.034 PMID: 37620196
pubmed: 37620196
pii: S0181-5512(23)00367-4
doi: 10.1016/j.jfo.2023.03.034
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

Copyright © 2023 Elsevier Masson SAS. All rights reserved.

Auteurs

R Nourinia (R)

Ophthalmic Research Center, Research Institute for Ophthalmology and Vision Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran; Labbafinejad Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

H Nouri (H)

Ophthalmic Research Center, Research Institute for Ophthalmology and Vision Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran; School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.

S-H Abtahi (SH)

Ophthalmic Research Center, Research Institute for Ophthalmology and Vision Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran; Labbafinejad Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

S Nakao (S)

Department of Ophthalmology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.

J Eslamipour (J)

Ophthalmic Research Center, Research Institute for Ophthalmology and Vision Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran; Labbafinejad Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran; Department of Ophthalmology, Faculty of Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran.

E Gerami (E)

Ophthalmic Research Center, Research Institute for Ophthalmology and Vision Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran; Labbafinejad Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

H Ahmadieh (H)

Ophthalmic Research Center, Research Institute for Ophthalmology and Vision Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran; Labbafinejad Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Electronic address: hahmadieh@hotmail.com.

Classifications MeSH