Optical coherence tomography and imaging biomarkers as outcome predictors in diabetic macular edema treated with dexamethasone implant

• Published in: Scientific reports Vol. 12; no. 1; p. 3872
• Main Authors: Chou, Hung-Da, Wu, Cheng-Hsiu, Chiang, Wei-Yu, Chen, Nan-Ni, Hwang, Yih-Shiou, Chen, Kuan-Jen, Lai, Chien-Hsiung, Wu, Pei-Chang, Chen, Yi-Hao, Yeung, Ling, Shao, Shih-Chieh, Lai, Chi-Chun, Wu, Wei-Chi
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 09.03.2022; Nature Publishing Group; Nature Portfolio
• Subjects: 631/1647; 692/53; Acuity; Biomarkers; Dexamethasone; Dexamethasone - therapeutic use; Diabetes; Diabetes Mellitus; Diabetic retinopathy; Diabetic Retinopathy - diagnostic imaging; Diabetic Retinopathy - drug therapy; Drug Implants - therapeutic use; Edema; Eye; Glucocorticoids - therapeutic use; Humanities and Social Sciences; Humans; Intravitreal Injections; Macular Edema - diagnostic imaging; Macular Edema - drug therapy; multidisciplinary; Photography; Retrospective Studies; Science; Science (multidisciplinary); Steroids; Tomography; Tomography, Optical Coherence - methods; Transplants & implants; Treatment Outcome; Visual Acuity
• ISSN: 2045-2322; 2045-2322
• DOI: 10.1038/s41598-022-07604-7

In this retrospective, multicenter study, we determined the predictive value of imaging biomarkers in diabetic macular edema (DME) outcomes following dexamethasone (DEX) implant(s). Sixty-seven eyes of 47 patients’ best-corrected visual acuity (BCVA) and central foveal thickness (CFT) on optical coherence tomography (OCT) before and after intravitreal DEX implants were evaluated. Baseline imaging biomarkers were graded using fundus photography and OCT, and the predictive value of biomarkers for significant treatment effects at six months was analyzed. Six months after 2.0 ± 0.8 (mean ± SD) DEX implants, 35 (52%) and 16 (24%) eyes had CFT reduction ≥ 10% from baseline and decreased to < 300 µm, respectively. BCVA improved ≥ 3 lines in 15 (22%) and remained stable in 38 (57%) eyes. At six months, eyes with severe intraretinal cyst (IRC), abundant hyperreflective dots (HRD), and moderate or severe hard exudate had a significantly higher chance of CFT reduction ≥ 10%. Eyes with abundant HRD at baseline and those underwent three DEX implants were more likely to achieve CFT < 300 µm. Eyes with DME and severe IRC, abundant HRD, or moderate-to-severe hard exudate at baseline were more likely to show a significant reduction in CFT six months after DEX implant.