Disorganization of retinal inner layers as a biomarker in patients with diabetic macular oedema treated with dexamethasone implant

the International Retina Group (IRG)

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose: To investigate disorganization of retinal inner layers (DRIL) as a biomarker in eyes with diabetic macular oedema (DME) treated by intravitreal dexamethasone (DEX) implant. Methods: Multicentre, retrospective study including eyes with DME treated with DEX implant and follow-up of 12 months after the first injection. OCT scans were evaluated for the presence of DRIL and other structural features. Best corrected visual acuity (BCVA) and central subfield thickness (CST) were recorded at baseline and at 2, 4, 6 and 12 months after treatment. Correlation between DRIL at baseline and outcomes after DEX treatment and the change in DRIL were analysed. Results: A total of 177 eyes (177 patients; naïve, n = 131; refractory, n = 46) were included. Patients without DRIL at baseline gained significantly more vision and enjoyed greater reduction in CST over 12 months (both p = 0.03). DRIL at the boundary between the ganglion cell-inner plexiform complex and inner nuclear layer improved in 48/64 eyes (75%, p < 0.001), while DRIL between the inner nuclear layer and outer plexiform layer improved in 27/77 eyes (35%, p = 0.004). Conclusions: This is the first study to show that DEX implant has the potential to ameliorate DRIL. Patients without DRIL at baseline have a favourable outcome. DRIL may serve a robust biomarker in DME treated by DEX implant.

Original languageEnglish
Pages (from-to)e217-e223
JournalActa Ophthalmologica
Volume98
Issue number2
DOIs
StatePublished - 1 Mar 2020

Keywords

  • Biomarker
  • dexamethasone implant
  • diabetic macular edema
  • disorganization of retinal inner layers
  • functional and anatomical outcomes

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