دورية أكاديمية
أعرض في EDS

Shall we stay, or shall we switch? Continued anti-VEGF therapy versus early switch to dexamethasone implant in refractory diabetic macular edema.

التفاصيل البيبلوغرافية
العنوان: Shall we stay, or shall we switch? Continued anti-VEGF therapy versus early switch to dexamethasone implant in refractory diabetic macular edema.
المؤلفون: Busch C; Department of Ophthalmology, University Hospital Leipzig, Liebigstr. 10-14, 04103, Leipzig, Germany. busch.catharina@gmail.com., Zur D; Division of Ophthalmology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel., Fraser-Bell S; Department of Ophthalmology, Sydney University, Sydney, Australia., Laíns I; Faculty of Medicine, University of Coimbra, Coimbra, Portugal.; Association for Innovation and Biomedical Research on Light, Coimbra, Portugal.; Massachusetts Eye and Ear, Harvard Medical School, Boston, USA., Santos AR; Association for Innovation and Biomedical Research on Light, Coimbra, Portugal.; School of Allied Health Technologies, Polytechnic Institute of Porto, Porto, Portugal., Lupidi M; Section of Ophthalmology, Department of Biomedical and Surgical Sciences, University of Perugia, Perugia, Italy., Cagini C; Section of Ophthalmology, Department of Biomedical and Surgical Sciences, University of Perugia, Perugia, Italy., Gabrielle PH; Ophthalmology Department, Dijon University Hospital, Dijon, France.; Center for Taste and Feeding Behaviour, INRA, UMR1324, Dijon, France., Couturier A; Department of Ophthalmology, Hôpital Lariboisière, AP-HP, Université Paris 7, Sorbonne Paris Cité, Paris, France., Mané-Tauty V; Department of Ophthalmology, Hôpital Lariboisière, AP-HP, Université Paris 7, Sorbonne Paris Cité, Paris, France., Giancipoli E; Department of Surgical, Microsurgical and Medical Sciences, Eye Clinic, University of Sassari, Sassari, Italy.; Department of Biomedical Sciences, University of Sassari, Sassari, Italy., Ricci GD; Department of Surgical, Microsurgical and Medical Sciences, Eye Clinic, University of Sassari, Sassari, Italy.; Department of Biomedical Sciences, University of Sassari, Sassari, Italy., Cebeci Z; Department of Ophthalmology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey., Rodríguez-Valdés PJ; Instituto de Oftalmología y Ciencias Visuales, Escuela de Medicina, Tecnológico de Monterrey, Monterrey, Mexico., Chaikitmongkol V; Retina Division, Department of Ophthalmology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand., Amphornphruet A; Department of Ophthalmology, Faculty of Medicine, Rajavithi Hospital, Rangsit University, Bangkok, Thailand., Hindi I; Division of Ophthalmology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel., Agrawal K; L.V. Prasad Eye Institute, Banjara Hills, Hyderabad, India., Chhablani J; L.V. Prasad Eye Institute, Banjara Hills, Hyderabad, India., Loewenstein A; Division of Ophthalmology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.; Incumbent, Sydney A. Fox Chair in Ophthalmology, Tel Aviv University, Tel Aviv, Israel., Iglicki M; Private Retina Service, University of Buenos Aires, Buenos Aires, Argentina., Rehak M; Department of Ophthalmology, University Hospital Leipzig, Liebigstr. 10-14, 04103, Leipzig, Germany.
مؤلفون مشاركون: International Retina Group
المصدر: Acta diabetologica [Acta Diabetol] 2018 Aug; Vol. 55 (8), pp. 789-796. Date of Electronic Publication: 2018 May 05.
نوع المنشور: Journal Article; Multicenter Study
اللغة: English
بيانات الدورية: Publisher: Springer Verlag Country of Publication: Germany NLM ID: 9200299 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1432-5233 (Electronic) Linking ISSN: 09405429 NLM ISO Abbreviation: Acta Diabetol Subsets: MEDLINE
أسماء مطبوعة: Publication: Berlin : Springer Verlag
Original Publication: Berlin : Springer International, c1991-
مواضيع طبية MeSH: Drug Substitution*, Angiogenesis Inhibitors/*administration & dosage , Dexamethasone/*administration & dosage , Diabetic Retinopathy/*drug therapy , Macular Edema/*drug therapy , Vascular Endothelial Growth Factor A/*antagonists & inhibitors, Aged ; Case-Control Studies ; Drug Administration Schedule ; Drug Implants ; Drug Resistance/drug effects ; Female ; Glucocorticoids ; Humans ; Intravitreal Injections ; Male ; Middle Aged ; Retrospective Studies ; Treatment Failure ; Visual Acuity/drug effects
مستخلص: Aims: To compare functional and anatomical outcomes of continued anti-vascular endothelial growth factor (VEGF) therapy versus dexamethasone (DEX) implant in eyes with refractory diabetic macular edema (DME) after three initial anti-VEGF injections in a real-world setting.
Methods: To be included in this retrospective multicenter, case-control study, eyes were required: (1) to present with early refractory DME, as defined by visual acuity (VA) gain ≤ 5 letters or reduction in central subfield thickness (CST) ≤ 20%, after a loading phase of anti-VEGF therapy (three monthly injections) and (2) to treat further with (a) anti-VEGF therapy or (b) DEX implant. Main outcome measures were change in visual acuity (VA) and central subfield thickness (CST) at 12 months. Due to imbalanced baseline characteristics, a matched anti-VEGF group was formed by only keeping eyes with similar baseline characteristics as those in the DEX group.
Results: A total of 110 eyes from 105 patients were included (anti-VEGF group: 72 eyes, DEX group: 38 eyes). Mean change in VA at 12 months was - 0.4 ± 10.8 letters (anti-VEGF group), and + 6.1 ± 10.6 letters (DEX group) (P = 0.004). Over the same period, mean change in CST was + 18.3 ± 145.9 µm (anti-VEGF group) and - 92.8 ± 173.6 µm (DEX group) (P < 0.001). Eyes in the DEX group were more likely to gain ≥ 10 letters (OR 3.71, 95% CI 1.19-11.61, P = 0.024) at month 12.
Conclusions: In a real-world setting, eyes with DME considered refractory to anti-VEGF therapy after three monthly injections which were switched to DEX implant and had better visual and anatomical outcomes at 12 months than those that continued treatment with anti-VEGF therapy.
فهرسة مساهمة: Keywords: Anti-VEGF therapy; Dexamethasone implant; Intravitreal therapy; Long-term outcome; Refractory diabetic macular edema
المشرفين على المادة: 0 (Angiogenesis Inhibitors)
0 (Drug Implants)
0 (Glucocorticoids)
0 (Vascular Endothelial Growth Factor A)
7S5I7G3JQL (Dexamethasone)
تواريخ الأحداث: Date Created: 20180507 Date Completed: 20180920 Latest Revision: 20181004
رمز التحديث: 20221213
DOI: 10.1007/s00592-018-1151-x
PMID: 29730822
قاعدة البيانات: MEDLINE
الوصف
تدمد:1432-5233
DOI:10.1007/s00592-018-1151-x