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Uveitic macular edema response to intravitreal dexamethasone implant is independent of optical coherence tomography findings

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Abstract

Purpose

To identify predictive response optical coherence tomography (OCT) findings in uveitic macular edema (UME) treated with intravitreal dexamethasone implant (DEX).

Methods

Retrospective study of 66 eyes (53 patients) treated with DEX for UME. SD-OCT macular scans were collected prior to DEX treatment and 6 weeks and 3 months after the DEX implant. OCT images were evaluated for qualitative and quantitative characteristics (central retinal thickness, CRT and macular volume, MV). A multivariate analysis of covariance (ANCOVA) was carried out to study the predictive influence of OCT and clinical covariates on outcomes. The main outcome was a composite endpoint based on the simultaneous gain of 5 or more letters associated with a 20% or more reduction in CRT.

Results

A significant improvement in BCVA at 6 weeks (mean change from baseline −0.2, SD 0.3) and 3 months (mean −0.2, SD 0.4) was observed after the DEX implant. A significant decrease in CRT (change from baseline −187.7 μm at 3 months) and MV (change from baseline −1.7 mm3 at 3 months) were also observed. An association of ≥ 5-letter improvement in BCVA and a ≥ 20% CRT reduction was observed in 44.6% of cases at 6 weeks and 31.4% at 3 months. ANCOVA multivariate analyses found CRT at 3 months independent from baseline clinical variables but from CRT.

Conclusion

DEX implant is an effective treatment for UME independently of basal characteristics, producing both a gain of visual acuity and improvement of macular anatomy by OCT measures at 3 months.

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Authors and Affiliations

  1. Hospital Clínic, Instituto Clínic de Oftalmologia (ICOF), University of Barcelona, Sabino de Arana 1, 08028, Barcelona, Spain

    Aina Moll-Udina, Marc Figueras-Roca, Anna Sala-Puigdollers, Carmen Alba-Linero, Victor Llorenç & Alfredo Adán

  2. Institut D’Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Barcelona, Spain

    Aina Moll-Udina, Marc Figueras-Roca, Anna Sala-Puigdollers, Victor Llorenç & Alfredo Adán

  3. Hospital Vall D’Hebron, Autonomous University of Barcelona, Barcelona, Spain

    Joan Oliveres

  4. Vall Hebron Research Institute, Autonomous University of Barcelona, Barcelona, Spain

    Cristina Esquinas

Authors
  1. Aina Moll-Udina
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  2. Marc Figueras-Roca
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  3. Joan Oliveres
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  4. Anna Sala-Puigdollers
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  5. Cristina Esquinas
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  6. Carmen Alba-Linero
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  7. Victor Llorenç
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  8. Alfredo Adán
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Contributions

A.M.-U conception of the paper, design of the paper, data analysis and interpretation, manuscript drafting, and literature search. M.F.-R. co-writing of the manuscript, data analysis and interpretation, design of the paper, manuscript editing and revision, as well as final approval. J.O. data collection, literature search, manuscript editing and final approval. A.S.-P., C.A.-L., V.L. and A.. manuscript editing, revision and final approval. C.E. statistics of the manuscript and final approval.

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Correspondence to Aina Moll-Udina.

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Moll-Udina, A., Figueras-Roca, M., Oliveres, J. et al. Uveitic macular edema response to intravitreal dexamethasone implant is independent of optical coherence tomography findings. Int Ophthalmol 41, 787–796 (2021). https://doi.org/10.1007/s10792-020-01631-x

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  • DOI: https://doi.org/10.1007/s10792-020-01631-x

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