Clinical Publications

TRITON

Optical Coherence Tomography Predictors of Favorable Functional Response in Naïve Diabetic Macular Edema Eyes Treated with Dexamethasone Implants as a First-Line Agent

AUTHORS:

Meduri A, Oliverio GW, Trombetta L, Giordano M, Inferrera L, Trombetta CJ.

PUBLICATION:

J Ophthal 2021; Article ID 6639418, 5 pages. DOI: 10.1155/2021/6639418

Study Purpose

To evaluate efficacy and safety of intravitreal dexamethasone 0.7mg implant in treatment-naïve DME patients and to assess the utility of OCT structural biomarkers as predictors of functional response after treatment.

Overview

Study Design

Longitudinal, cross sectional stud

# of Eyes/
Patients

• Thirty-nine patients (19 males, 20 females) with DME. Twenty-one patients (53.8%) presented cystoid macular edema, 18 patients (46.2%) presented a subfoveal neuroretinal detachment.

Study Device

DRI Triton SS-OCT (Topcon, Tokyo, Japan)

Outcome Measures

• Possible OCT biomarkers CRT(central retinal thickness), IRC (intraretinal cysts), CT (choroidal thickness), SRD(serous retinal detachment), HRS (hyperreflective spots), EZ (ellipsoid zone), VMA (vitreomacular adhesions) as predictive factors for visual acuity improvement after 3, 6 and 12months following treatment

Results

Figure 1 shows the structural biomarkers evaluated over a 3mm area.
At 3 months the mean BCVA improved from 51.6+ 17.1 to 58.9 + 16.5 ETDRS letters (p=0.01) and to 57.6+17.3 and to 56.9+ 17.5 at 6 and 12 months respectively (p=0.03).
There were statistically significant changes in CRT, IRC dimension, HRS number and SRD height after treatment throughout follow-up. No significant changes in CT were observed.
A >10-letter improvement in BCVA was present in 48.7% of the patients at the end of follow-up.
The presence of EZ integrity and SRD at baseline were predictors of good functional treatment response at 12 months.
Eyes without vitreoretinal interface alterations at baseline presented a better functional outcome at 12 months.

IMOvifa reduced measurement time by

39%

FIGURE 1

FIGURE 1.

SS-OCT radial scan (9mm)... showing structural biomarkers evaluated within a 3mm area centered on the fovea. Adapted from J Ophthal 2021; Article ID 6639418, 5 pages. DOI: 10.1155/2021/6639418.

Conclusions

• The study confirmed the efficacy and safety of intravitreal dexamethasone implant in the treatment of naïve DME patients and demonstrated a better functional response in patients with the presence of SRD and EZ integrity and absence of vitreomacular alterations; however, further studies are necessary to assess the usefulness of OCT structural biomarkers as predictors of functional response in DME patients. • The authors stated that the improvement in BCVA of >10-letters in 48.7% was in accordance with previous findings1 • Findings emphasize the importance of accurate evaluation of structural biomarkers to choose the best treatment for the patient.