ESASO classification relevance in the diagnosis and evolution in diabetic macular edema patients after dexamethasone implant treatment

• Published in: Graefe's archive for clinical and experimental ophthalmology Vol. 262; no. 9; pp. 2813 - 2821
• Main Authors: Moreno-Martínez, Almudena, Blanco-Marchite, Cristina, Andres-Pretel, Fernando, López-Martínez, Francisco, Donate-Tercero, Antonio, González-Aquino, Eva, Cava-Valenciano, Carlos, Panozzo, Giacomo, Copete, Sergio
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.09.2024; Springer Nature B.V
• Subjects: Acuity; Aged; Biomarkers; Classification; Dexamethasone; Dexamethasone - administration & dosage; Diabetes; Diabetes mellitus; Diabetic Retinopathy - classification; Diabetic Retinopathy - diagnosis; Diabetic Retinopathy - drug therapy; Diabetic Retinopathy - physiopathology; Drug Implants; Edema; Female; Follow-Up Studies; Glucocorticoids - administration & dosage; Humans; Intravitreal Injections; Macula Lutea - diagnostic imaging; Macula Lutea - pathology; Macular Edema - classification; Macular Edema - diagnosis; Macular Edema - drug therapy; Macular Edema - etiology; Male; Medicine; Medicine & Public Health; Middle Aged; Ophthalmology; Patients; Retinal Disorders; Retrospective Studies; Tomography; Tomography, Optical Coherence - methods; Visual Acuity; Biomarker; ESASO classification; Intravitreal dexamethasone implant; Outcomes; Diabetic macular edema
• ISSN: 0721-832X; 1435-702X; 1435-702X
• DOI: 10.1007/s00417-024-06473-2

Purpose To assess the clinical relevance of The European School for Advanced Studies in Ophthalmology (ESASO) classification in patients with diabetic macular edema (DME) after their first dexamethasone implant (DEXI) treatment. Methods Retrospective real-world study conducted on consecutive DME patients who underwent DEXI treatment and were controlled at month-2. Subjects were initially classified according to the ESASO classification stages. The outcomes were anatomical biomarkers with spectral-domain optical coherence tomography (SD-OCT) and best-corrected visual acuity (BCVA). Results A total of 128 patients were classified according to ESASO classification stages as early (7; 5.5%), advanced (100; 78.1%), and severe (21; 16.4%). At baseline, there were significant differences between stages in BCVA, central macular thickness (CMT), and tomography anatomical biomarkers ( p  < 0.05). Initial BCVA (logMAR) was 0.33 ± 0.10, 0.58 ± 0.34, and 0.71 ± 0.35 in the early, advanced, and severe stages, respectively ( p  < 0.05). At month-2, BCVA was 0.17 ± 0.15, 0.46 ± 0.29, and 0.69 ± 0.27 in those classified as early, advanced, and severe stages, respectively. At month-2, DME was resolved or improved in 6 (85.7%), 60 (60%), and 12 (60%) patients classified as early, advanced, and severe stages, respectively. Conclusions There was a good correlation between BCVA and ESASO classification stages. Patients in the severe stage did not achieve visual acuity improvement over the study period.