The Prognostic Role of Optical Coherence Tomography in Diabetic Macular Edema Patients Undergoing Early Dexamethasone Implant Shift

Author: Mehmet Murat Uzel (Turkey)

Co-authors: Eyyup Karahan, Melek Koroglu Canlı, Cenap Güler

Purpose

To determine the prognostic features of optic coherence tomography (OCT) parameters by evaluating diabetic macular edema (DME) patients with dexamethasone (DEX) shift in the early period.

Setting/Venue

Retrospective, observational study

Methods

Fifty-four eyes of 34 patients who had DEX implant after three doses of ranibizumab (RNB) were included in this study. Baseline OCT values and factors before Ranibizumab treatment affecting best corrected visual acuity (BCVA) and central macular thickness (CMT) response 3 months after DEX implant were analyzed with logistic regression analyses.

Results

The presence of subretinal fluid and hyperreflective spot (HRS) >20 were found to be a negative predictive factor for anatomical response. (p=0.009, p=0.001, respectively) Low initial BCVA creates a positive effect on visual gain.(p=0.041) Giant outer nuclear layer cysts, completely disrupted inner segment-outer segment and HRS>20 have a negative effect on visual gain. (p=0.025, p=0.043, p=0.023, respectively) According to the receiver operating characteristic analysis, the subretinal fluid volume threshold at which >20% reduction in CMT occurs was determined to be 0.85 mm3. (sensitivity 70%, specificity 84% area under the curve 0.817 p=0.021).

Conlusions

The presence of high number of HRS and high subretinal fluid volume at the baseline negatively affect prognosis even in patient groups with early DEX shift.

Financial Disclosure

none