TY - JOUR
T1 - A Collaborative Retrospective Study on the Efficacy and Safety of Intravitreal Dexamethasone Implant (Ozurdex) in Patients with Diabetic Macular Edema
T2 - The European DME Registry Study
AU - ARTES Study Group
AU - Rosenblatt, Amir
AU - Udaondo, Patricia
AU - Cunha-Vaz, José
AU - Sivaprasad, Sobha
AU - Bandello, Francesco
AU - Lanzetta, Paolo
AU - Kodjikian, Laurent
AU - Goldstein, Michaella
AU - Habot-Wilner, Zohar
AU - Loewenstein, Anat
AU - Escobar, Jose Juan
AU - Menon, Geeta
AU - Corcostegui, Borja
AU - Eriksson, Urban
AU - Boixadera, Anna
AU - Sararols, Laura
AU - Guigou, Sebastien
AU - Varano, Monica
AU - Figueira, João
AU - Pollack, Ayalla
AU - Massin, Pascale
AU - Carpineto, Paolo
AU - Recchimurzo, Nicola
AU - Matonti, Frederic
AU - Kinnunen, Kati
AU - Coscas, Florence
AU - Midena, Edoardo
AU - Nascimento, João
AU - Armada, Felix
AU - Sorkin, Nir
AU - Habot-Wilner, Zohar
N1 - Publisher Copyright:
© 2019 American Academy of Ophthalmology
PY - 2020/3
Y1 - 2020/3
N2 - Purpose: To evaluate the efficacy, effect profile, and safety of dexamethasone implant on diabetic macular edema (DME) in a real-life setting, further comparing results by DME duration, previous treatment status, and diabetic control. Design: A multicenter, retrospective cohort of 340 DME eyes of 287 patients from 25 clinical sites from 8 countries. Methods: Data were analyzed in 2 perspectives: per injection, in which all measurements were grouped and baseline was defined as the day of injection, and thus the pharmacodynamics of single injections could be assessed; and injection series, defined as 2 or more injections with 3 to 6 months between injections analyzing the outcome 3 to 6 months after the last injection. Main Outcome Measures: Primary outcome was improvement of 15 or more letters in best-corrected visual acuity (BCVA) from baseline. Secondary outcomes included improvement of 10 letters or more in BCVA, change in central macular thickness (CMT), and time to maximum improvement and safety. Results: Overall, 762 injections were administered to 340 eyes of 287 patients. Injection series analysis included 171 series in 171 eyes of 150 patients, for a total of 444 injections, with a mean follow-up of 1.7±0.8 years. Of the 762 injections analyzed per injection, 22.7% achieved a 15-letter or more improvement, and 37.8% achieved a 10-letter or more improvement. Mean time to peak improvement was 81.9±39.7 days. Mean maximum change in CMT was –174±171 μm. Overall, 7.6% lost 15 or more letters. More eyes with early DME gained 10 or more letters and fewer eyes lost 10 or more letters compared with eyes with late DME (47.4% vs. 33.9% [P = 0.001] and 8.2% vs. 13.5% [P = 0.029], respectively). Patients with controlled diabetes showed greater CMT reduction (P = 0.0002). A higher percentage of treatment-naive patients gained 10 or 15 letter or more in BCVA (P = 0.001 and P = 0.006, respectively). Intraocular pressure elevation of more than 25 mmHg was found following 7.9% of injections; no endophthalmitis was reported. Conclusions: Dexamethasone implant is an effective and safe treatment for DME. Peak improvement was achieved 3 months after injection and dissipated thereafter. Clinicians and providers may consider shortening treatment intervals.
AB - Purpose: To evaluate the efficacy, effect profile, and safety of dexamethasone implant on diabetic macular edema (DME) in a real-life setting, further comparing results by DME duration, previous treatment status, and diabetic control. Design: A multicenter, retrospective cohort of 340 DME eyes of 287 patients from 25 clinical sites from 8 countries. Methods: Data were analyzed in 2 perspectives: per injection, in which all measurements were grouped and baseline was defined as the day of injection, and thus the pharmacodynamics of single injections could be assessed; and injection series, defined as 2 or more injections with 3 to 6 months between injections analyzing the outcome 3 to 6 months after the last injection. Main Outcome Measures: Primary outcome was improvement of 15 or more letters in best-corrected visual acuity (BCVA) from baseline. Secondary outcomes included improvement of 10 letters or more in BCVA, change in central macular thickness (CMT), and time to maximum improvement and safety. Results: Overall, 762 injections were administered to 340 eyes of 287 patients. Injection series analysis included 171 series in 171 eyes of 150 patients, for a total of 444 injections, with a mean follow-up of 1.7±0.8 years. Of the 762 injections analyzed per injection, 22.7% achieved a 15-letter or more improvement, and 37.8% achieved a 10-letter or more improvement. Mean time to peak improvement was 81.9±39.7 days. Mean maximum change in CMT was –174±171 μm. Overall, 7.6% lost 15 or more letters. More eyes with early DME gained 10 or more letters and fewer eyes lost 10 or more letters compared with eyes with late DME (47.4% vs. 33.9% [P = 0.001] and 8.2% vs. 13.5% [P = 0.029], respectively). Patients with controlled diabetes showed greater CMT reduction (P = 0.0002). A higher percentage of treatment-naive patients gained 10 or 15 letter or more in BCVA (P = 0.001 and P = 0.006, respectively). Intraocular pressure elevation of more than 25 mmHg was found following 7.9% of injections; no endophthalmitis was reported. Conclusions: Dexamethasone implant is an effective and safe treatment for DME. Peak improvement was achieved 3 months after injection and dissipated thereafter. Clinicians and providers may consider shortening treatment intervals.
UR - http://www.scopus.com/inward/record.url?scp=85077702571&partnerID=8YFLogxK
U2 - 10.1016/j.ophtha.2019.10.005
DO - 10.1016/j.ophtha.2019.10.005
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C2 - 31932090
AN - SCOPUS:85077702571
SN - 0161-6420
VL - 127
SP - 377
EP - 393
JO - Ophthalmology
JF - Ophthalmology
IS - 3
ER -