scholarly journals Optical Coherence Tomography Angiography Characteristics Serve as Retinal Vein Occlusion Therapeutic Biomarkers for Dexamethasone Intravitreal Implant

2021 ◽  
Vol 2021 ◽  
pp. 1-21
Author(s):  
Ke Shi ◽  
Xiaodong Sun ◽  
Jingfa Zhang
Keyword(s):  
Bioinformatic Analysis ◽  
Macular Thickness ◽  
Functional Enrichment ◽  
Dexamethasone Implant ◽  
Dexamethasone Intravitreal Implant ◽  
Vein Occlusion ◽  
Intravitreal Dexamethasone Implant ◽  
Intravitreal Implant ◽  
Before And After ◽  
Intravitreal Dexamethasone

Background. Retinal vein occlusion (RVO) is the second most common vision-threatening retinal vascular disease. Intravitreal dexamethasone implant has been applied to treat macular edema secondary to RVO (RVO-ME). However, the alteration of morphologic features detected with optical coherence tomography angiography (OCTA) has not been fully studied in RVO-ME patients before and after the treatment. Objective. This study is aimed at identifying potential therapeutic targets in RVO with integrative bioinformatic analysis and compares the OCTA characteristics alterations in patients with RVO-ME receiving injection of dexamethasone intravitreal implant. Methods. Bioinformatic analysis was analyzed in GSE101398 dataset from the Gene Expression Omnibus database. Multiple functional enrichment analyses were performed, and protein-protein interaction network was constructed to visualize the key node genes. Eleven eyes with RVO-ME were examined with OCTA before and after intravitreal dexamethasone implant. The OCTA parameters, including macular thickness, vessel density, foveal avascular zone parameters, the number of hyperreflective foci (HRF), area of cystoid edema, and subretinal fluid (SRF), were compared. The correlation was analyzed between best-corrected visual acuity (BCVA) and OCTA parameters. Results. A total of 79 differentially expressed genes were identified. Functional enrichment analyses revealed the enriched inflammatory events in RVO. In RVO-ME, Pearson correlation revealed that baseline BCVA was positively correlated with the area of SRF and central macular thickness, while no correlation was detected between baseline BCVA and HRF number or the area of cystoid edema. The visual acuity improved, and the central macular thickness was decreased after intravitreal dexamethasone implant injection. Besides, the number of HRF, the area of cystoid edema, and SRF were significantly alleviated after dexamethasone intravitreal injection. Conclusion. Retinal inflammation plays a crucial role in RVO pathogenesis. The imaging biomarkers of RVO including Müller glial intracellular edema, and retinal pigment epithelium dysfunction, could be assessed in OCTA and attenuated by intravitreal dexamethasone implant effectively.

Short-term effectiveness prognostic factors after dexamethasone intravitreal implant in macular edema due to retinal vein occlusion

2021 ◽  
pp. 112067212110325
Author(s):  
Gonzaga Garay-Aramburu ◽  
Ángela Gómez-Moreno ◽  
Aritz Urcola
Keyword(s):  
Macular Edema ◽  
Retinal Vein Occlusion ◽  
Clinical Predictors ◽  
Short Term ◽  
Dexamethasone Intravitreal Implant ◽  
Vein Occlusion ◽  
Intravitreal Dexamethasone Implant ◽  
Intravitreal Implant ◽  
Intravitreal Dexamethasone ◽  
Anatomical Outcomes

Introduction: The aim of this study was to describe functional and anatomical changes (best-corrected visual acuity [BCVA], central macular thickness [CMT], and central macular volume [CMV]) in patients with macular edema (ME) secondary to retinal vein occlusion (RVO) treated with intravitreal dexamethasone implant (IDI) and identify its clinical predictors in a real-world setting. Methods: Data from 111 patients who underwent IDI to treat RVO-associated ME were retrospectively reviewed. Demographic, preoperative, and postoperative variables were assessed using a logistic regression analysis to determine predictors of visual and anatomical improvement. Results: Mean BCVA, CMT, and CMV improved from baseline after IDI ( p < 0.001). The strongest predictors of different treatment outcomes were: a baseline BCVA ⩽60 ETDRS letters (OR = 50.600; p < 0.001) and first IDI injection (OR = 2.988; p < 0.001) for BCVA gain ⩾15 Early Treatment Diabetic Retinopathy Study (ETDRS) letters; a baseline BCVA ⩽60 ETDRS letters (OR = 7.893; p = 0.002) and non-chronic ME (OR = 3.875; p = 0.019) for BCVA ⩾80 ETDRS letters achievement; a baseline CMT ⩾400 µm (OR = 49.083; p  < 0.001) and a baseline CMV ⩾12 mm3 (OR = 4.235; p < 0.001) for CMT reduction ⩾50%; and a baseline CMT ⩾400 µm (OR = 11.471; p  < 0.001) and a baseline CMV ⩾12 mm3 (OR = 10.284; p < 0.001) for CMV reduction ⩾15%. Conclusion: This study confirmed the effectiveness of IDI to treat ME secondary to RVO and identified new predictive factors for two visual (⩾15 ETDRS letters gain and BCVA ⩾80 ETDRS letters) and two anatomical outcomes (>50% CMT and >15% CMV reduction).

Anterior chamber changes assessment by Scheimpflug analysis after intravitreal dexamethasone implantation

2021 ◽  
pp. 112067212110294
Author(s):  
Elvan Kucukkomurcu ◽  
Tayfun Sahin
Keyword(s):  
Anterior Chamber ◽  
Structural Changes ◽  
Anterior Chamber Depth ◽  
Applanation Tonometry ◽  
Dexamethasone Implant ◽  
Vein Occlusion ◽  
Intravitreal Dexamethasone Implant ◽  
Before And After ◽  
Intravitreal Dexamethasone ◽  
Initial Measurement

Purpose: To evaluate structural changes in the anterior chamber and intraocular pressure (IOP) changes following intravitreal dexamethasone implantation. Methods: Forty-two eyes of 42 patients that received intravitreal dexamethasone implant for the management of macular edema secondary to diabetic retinopathy or branch retinal vein occlusion (BRVO) were included in the study. IOP was measured by Goldmann applanation tonometry. Anterior chamber depth (ACD) and iridocorneal angle (ICA) was measured by a Scheimflug camera (Sirius, CSO, Italy) the day before the injection of the dexamethasone implant and on postoperative day 1, first week, and first month. Results: Mean IOP was 15.14 ± 2.77 mmHg before the procedure and, 15.67 ± 3.70 mmHg, 15.86 ± 3.11 mmHg, 16.21 ± 2.75 mmHg on day 1, first week, and first month following intravitreal dexamethasone implantation, respectively. Mean ICA and ACD were significantly higher in pseudophakic eyes compared to phakic eyes. However, there was no statistically significant change in ICA before and after the procedure (on postoperative day 1, first week, and first month) among both phakic and pseudophakic patients ( p = 0.783). Similarly, ACD remained unchanged after the procedure (on postoperative day 1, first week, and first month) compared to the initial measurement ( p = 0.802). Conclusion: This study confirmed that there was an increase in IOP. However, these changes were not accompanied with a change in ACD or ICA.

scholarly journals Combined Phacoemulsification and Intravitreal Dexamethasone Implant (Ozurdex®) in Diabetic Patients with Coexisting Cataract and Diabetic Macular Edema

2017 ◽  
Vol 2017 ◽  
pp. 1-7 ◽  
Author(s):  
Claudio Furino ◽  
Francesco Boscia ◽  
Alfredo Niro ◽  
Ermete Giancipoli ◽  
Maria Oliva Grassi ◽  
...  
Keyword(s):  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Topical Therapy ◽  
Secondary Outcome ◽  
Diabetic Patients ◽  
Dexamethasone Implant ◽  
Ocular Complications ◽  
Dexamethasone Intravitreal Implant ◽  
Intravitreal Dexamethasone Implant ◽  
Intravitreal Dexamethasone

Purpose. To investigate the effectiveness and safety of combined phacoemulsification and dexamethasone intravitreal implant in patients with cataract and diabetic macular edema. Methods. In this two-center, retrospective, single-group study, the charts of 16 consecutive patients who underwent combined phacoemulsification and intravitreal dexamethasone implant were retrospectively reviewed. These 16 patients, 7 men and 9 women, were observed at least 3 months of follow-up. Primary outcome was the change of the central retinal thickness (CRT); secondary outcome was the change of best-corrected visual acuity (BCVA). Any ocular complications were recorded. Results. Mean CRT decreased significantly from 486 ± 152.4 μm at baseline to 365.5 ± 91 μm at 30 days (p=.005), to 326 ± 80 μm at 60 days (p=.0004), and to 362 ± 134 μm at 90 days (p=.001). Mean BCVA was 20/105 (logMAR, 0.72 ± 0.34) at baseline and improved significantly (p≤.007) at all postsurgery time points. One case of ocular hypertension was observed and successfully managed with topical therapy. No endophthalmitis or other ocular complications were observed. Conclusion. Intravitreal slow-release dexamethasone implant combined with cataract surgery may be an effective approach on morphologic and functional outcomes for patients with cataract and diabetic macular edema for at least three months after surgery.

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