Visual Acuity Gain Profiles and Anatomical Prognosis Factors in Patients with Drug-Naive Diabetic Macular Edema Treated with Dexamethasone Implant: The NAVEDEX Study

• Main Authors: Mauricio Pinto (Author), Thibaud Mathis (Author), Pascale Massin (Author), Jad Akesbi (Author), Théo Lereuil (Author), Nicolas Voirin (Author), Frédéric Matonti (Author), Franck Fajnkuchen (Author), John Conrath (Author), Solange Milazzo (Author), Jean-François Korobelnik (Author), Stéphanie Baillif (Author), Philippe Denis (Author), Catherine Creuzot-Garcher (Author), Mayer Srour (Author), Bénédicte Dupas (Author), Aditya Sudhalkar (Author), Alper Bilgic (Author), Ramin Tadayoni (Author), Eric H Souied (Author), Corinne Dot (Author), Laurent Kodjikian (Author)
• Format: Book
• Published: MDPI AG, 2021-02-01T00:00:00Z.
• Subjects: article
• Online Access: Connect to this object online.

Summary

The purpose of this study is to evaluate the visual acuity (VA) gain profiles between patients with drug-naive diabetic macular edema (DME) treated by dexamethasone implant (DEX-implant) and assess the baseline anatomical and functional factors that could influence the response to the treatment in real-life conditions. A retrospective, multi-center observational study included 129 eyes with drug-naive DME treated by DEX-implant. The Median follow-up was 13 months. Two groups of VA gain trajectories were identified-Group A, with 71% (<i>n</i> = 96) of patients whose average VA gain was less than five letters and Group B, with 29% (<i>n</i> = 33) of patients with an average gain of 20 letters. The probability of belonging to Group B was significantly higher in patients with baseline VA < 37 letters (<i>p</i> = 0.001). Ellipsoid zone alterations (EZAs) or disorganization of retinal inner layers (DRILs) were associated with a lower final VA (53.0 letters versus 66.4, <i>p</i> = 0.002) but without a significant difference in VA gain (4.9 letters versus 6.8, <i>p</i> = 0.582). Despite a low baseline VA, this subgroup of patients tends to have greater visual gain, encouraging treatment with DEX-implant in such advanced-stage disease. However, some baseline anatomic parameters, such as the presence of EZAs or DRILs, negatively influenced final vision.

Item Description

10.3390/pharmaceutics13020194
1999-4923