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Research article
Javier Zarranz-Ventura
Hospital Clinic de Barcelona Institut Clinic d'Oftalmologia
Corresponding Author
ORCiD: https://orcid.org/0000-0003-2338-8143
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background
To identify different response patterns to intravitreal dexamethasone implants (IDI) in naïve and previously treated diabetic macular edema (DME) eyes in a real-life setting.
Methods
342 IDI injections (203 DME eyes) were included. Number of IDI injections, percentage (%) of eyes with 1, 2, 3 and ≥ 4 injections, time to reinjections, visual acuity (VA), intraocular pressure (IOP) and central retinal thickness (CRT) were evaluated for naïve and previously treated (PT) DME eyes over 24 months.
Results
Mean number of injections was significantly lower in naïve vs PT DME eyes (1.40 ± 0.9 vs 1.82 ± 0.9, p < 0.001). The percentage of eyes receiving 1 (76.1 vs 47.7), 2 (16.4 vs 29.4), or 3 injections (1.4 vs 17.6) was significantly lower in naïve vs PT DME eyes (p < 0.001), however no differences were observed in eyes receiving ≥4 injections (5.9 vs 5.1 respectively, p = 0.80). Mean time to reinjection was not significantly different between both groups for the second, third and fourth injection (9.6 ± 4.0 vs 10.0 ± 5.5, p = 0.75, 13.2 ± 4.0 vs 16.0 ± 3.5, p = 0.21 and 21.7 ± 3.8 vs 19.7 ± 5.8, p = 0.55). VA scores were consistently better in naïve vs PT DME eyes at all studied timepoints, with no significant differences in CRT reduction or adverse effect rates.
Conclusion
Naïve DME eyes required lower number of IDI injections and maintained better VA levels than PT DME eyes for 24 months in a real-world setting. This data supports the IDI use in early DME stages and provide further evidence of better IDI performance when used as first-line therapy.
Keywords
Diabetic Macular Edema, Real world setting, Naïve, Previously treated, Refractory, Dexamethasone, Implant, Ozurdex, Audit, Benchmark standard
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Peer Review Timeline
CURRENT STATUS: Published
View the published article at BMC Ophthalmology.
No community comments so far
Editorial decision: Accept
On 01 Nov, 2020
Review #1 received
Received 24 Oct, 2020
Reviewers invited
Invitations sent on 13 Oct, 2020
Reviewer #1 agreed
On 13 Oct, 2020
Editor assigned
On 08 Oct, 2020
Submission checks complete
On 07 Oct, 2020
Editor invited
On 07 Oct, 2020
Version 1
Posted 04 Sep, 2020
No comments provided
Review #1 received
Received 04 Oct, 2020
Editorial decision: Minor revision
On 04 Oct, 2020
Review #3 received
Received 27 Sep, 2020
Review #2 received
Received 19 Sep, 2020
Reviewer #3 agreed
On 16 Sep, 2020
Reviewer #2 agreed
On 14 Sep, 2020
Reviewers invited
Invitations sent on 07 Sep, 2020
Reviewer #1 agreed
On 07 Sep, 2020
Editor assigned
On 01 Sep, 2020
First submitted
On 31 Aug, 2020
Submission checks complete
On 31 Aug, 2020
Editor invited
On 31 Aug, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Ophthalmology
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A new preprint design is coming!
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See the published version of this preprint at BMC Ophthalmology.
This is a preprint, a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
Javier Zarranz-Ventura
Hospital Clinic de Barcelona Institut Clinic d'Oftalmologia
Corresponding Author
ORCiD: https://orcid.org/0000-0003-2338-8143
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Published
View the published article at BMC Ophthalmology.
No community comments so far
Editorial decision: Accept
On 01 Nov, 2020
Review #1 received
Received 24 Oct, 2020
Reviewers invited
Invitations sent on 13 Oct, 2020
Reviewer #1 agreed
On 13 Oct, 2020
Editor assigned
On 08 Oct, 2020
Submission checks complete
On 07 Oct, 2020
Editor invited
On 07 Oct, 2020
Version 1
Posted 04 Sep, 2020
No comments provided
Review #1 received
Received 04 Oct, 2020
Editorial decision: Minor revision
On 04 Oct, 2020
Review #3 received
Received 27 Sep, 2020
Review #2 received
Received 19 Sep, 2020
Reviewer #3 agreed
On 16 Sep, 2020
Reviewer #2 agreed
On 14 Sep, 2020
Reviewers invited
Invitations sent on 07 Sep, 2020
Reviewer #1 agreed
On 07 Sep, 2020
Editor assigned
On 01 Sep, 2020
First submitted
On 31 Aug, 2020
Submission checks complete
On 31 Aug, 2020
Editor invited
On 31 Aug, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Ophthalmology
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published article at BMC Ophthalmology.
Background
To identify different response patterns to intravitreal dexamethasone implants (IDI) in naïve and previously treated diabetic macular edema (DME) eyes in a real-life setting.
Methods
342 IDI injections (203 DME eyes) were included. Number of IDI injections, percentage (%) of eyes with 1, 2, 3 and ≥ 4 injections, time to reinjections, visual acuity (VA), intraocular pressure (IOP) and central retinal thickness (CRT) were evaluated for naïve and previously treated (PT) DME eyes over 24 months.
Results
Mean number of injections was significantly lower in naïve vs PT DME eyes (1.40 ± 0.9 vs 1.82 ± 0.9, p < 0.001). The percentage of eyes receiving 1 (76.1 vs 47.7), 2 (16.4 vs 29.4), or 3 injections (1.4 vs 17.6) was significantly lower in naïve vs PT DME eyes (p < 0.001), however no differences were observed in eyes receiving ≥4 injections (5.9 vs 5.1 respectively, p = 0.80). Mean time to reinjection was not significantly different between both groups for the second, third and fourth injection (9.6 ± 4.0 vs 10.0 ± 5.5, p = 0.75, 13.2 ± 4.0 vs 16.0 ± 3.5, p = 0.21 and 21.7 ± 3.8 vs 19.7 ± 5.8, p = 0.55). VA scores were consistently better in naïve vs PT DME eyes at all studied timepoints, with no significant differences in CRT reduction or adverse effect rates.
Conclusion
Naïve DME eyes required lower number of IDI injections and maintained better VA levels than PT DME eyes for 24 months in a real-world setting. This data supports the IDI use in early DME stages and provide further evidence of better IDI performance when used as first-line therapy.
Figure 1
Figure 2
Figure 3
Figure 4
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