New Landmarks, Signs, and Findings in Optical Coherence Tomography

Lara-Medina, F. J.; Esteban, O.; Bartolomé, I.; Ispa, C.; Mateo, Javier; Ascaso, Francisco J.

doi:10.5772/intechopen.84242

Cited by 1 publication

(1 citation statement)

References 82 publications

(123 reference statements)

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“…However, not all patients respond equally to anti-VEGF treatment. Few characteristics defined in other studies [2][3][4] which suggest favourable or unfavourable outcomes with treatment are (1) type of DME, that is, diffuse, cystic or serous retinal detachment (SRD), (2) hyper-reflective dots (HRD), (3) external limiting membrane (ELM) and inner segment-outer segment (IS-OS) junction integrity and (4) disorganization of retinal inner layers (DRIL).…”

Section: Introductionmentioning

confidence: 99%

Short-term outcomes of intravitreal dexamethasone in relation to biomarkers in diabetic macular edema

Narnaware¹,

Bawankule²,

Raje³

2020

European Journal of Ophthalmology

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Purpose: The purpose of this study was to determine the effects of dexamethasone implant (0.7 mg) on biomarkers such as hyper-reflective dots, external limiting membrane integrity and disorganization of retinal inner layers in treatment-naïve patients, patients who received less than three anti-vascular endothelial growth factor injections and non-responder cases with diabetic macular edema and its effects on edema and visual acuity. Methods: This is a prospective study of treatment-naïve patients, patients who received less than three anti-vascular endothelial growth factor injections and non-responder patients with diabetic macular edema, treated with single dexamethasone implant. Pre- and post-injection-based best-corrected visual acuity, central macular thickness, hyper-reflective dots, external limiting membrane integrity and disorganization of retinal inner layers were assessed. Results: A total of 27 diabetic macular edema eyes, including 9 non-responder eyes, 9 eyes which received less than three anti-vascular endothelial growth factor injections and 9 treatment-naïve eyes, were included in this study. Baseline hyper-reflective dots were 22.22 ± 11.76, 30 ± 7.91 and 19.44 ± 8.82 which reduced to 3.33 ± 1.32, 9 ± 8.35 and 8.78 ± 2.53 four months after implant in treatment-naïve patients, patients who received less than three anti-vascular endothelial growth factor injections and non-responder cases, respectively. Baseline central macular thickness was 589.44 ± 175.37, 537 ± 181.81 and 673.11 ± 138.24 and the central macular thickness after dexamethasone implant was 272.11 ± 39.00, 336.44 ± 132.88 and 524.00 ± 200.39 in treatment-naïve patients, patients who received less than three anti-vascular endothelial growth factor injections and non-responder cases, respectively. External limiting membrane integrity was restored in two patients in each group, whereas two patients with disorganization of retinal inner layers in treatment-naïve group showed reorganization of retinal structures after treatment with dexamethasone implant. Conclusion: Better response to dexamethasone implant in cases with more hyper-reflective dots shows that these hyper-reflective dots can be used as a predictive biomarker. Dexamethasone implant might help in restoring external limiting membrane integrity and resolution of disorganization of retinal inner layers.

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