GRAding of functional and anatomical response to DExamethasone implant in patients with Diabetic Macular Edema: GRADE-DME Study

Abstract To analyze functional and anatomical response patterns to dexamethasone (DEX) implant in diabetic macular edema (DME), to describe proportion of responders and non-responders, and to propose a new DME grading system. Retrospective, multicenter, observational cohort study. Naïve and non-naïv...

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Autores principales:	Patricio J. Rodríguez-Valdés, Matus Rehak, Dinah Zur, Anna Sala-Puigdollers, Samantha Fraser-Bell, Marco Lupidi, Jay Chhablani, Zafer Cebeci, Inês Laíns, Voraporn Chaikitmongkol, Adrian T. Fung, Mali Okada, Jan Darius Unterlauft, Lital Smadar, Anat Loewenstein, Matias Iglicki, Catharina Busch
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/e10c639ba77b4a99a4f809f2a0eff5c0
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spelling	oai:doaj.org-article:e10c639ba77b4a99a4f809f2a0eff5c02021-12-02T15:53:58ZGRAding of functional and anatomical response to DExamethasone implant in patients with Diabetic Macular Edema: GRADE-DME Study10.1038/s41598-020-79288-w2045-2322https://doaj.org/article/e10c639ba77b4a99a4f809f2a0eff5c02021-02-01T00:00:00Zhttps://doi.org/10.1038/s41598-020-79288-whttps://doaj.org/toc/2045-2322Abstract To analyze functional and anatomical response patterns to dexamethasone (DEX) implant in diabetic macular edema (DME), to describe proportion of responders and non-responders, and to propose a new DME grading system. Retrospective, multicenter, observational cohort study. Naïve and non-naïve DME patients were treated with DEX, with visual acuity (VA) ≥ 0.2 logMAR and central subfield thickness (CST) of ≥ 300 µm. Functional and anatomical responses were graded after 2 and 4 months, and categorized as early and stable improvement, early and progressive improvement, pendular response, delayed improvement, and persistent non-response. 417 eyes were included (175 treatment naïve eyes). Compared to non-naïve eyes, naïve eyes showed a very good functional response (VA gain ≥ 10 letters) more frequently after 2 and 4 months (56% and 57% [naïve] vs. 33% and 28% [non-naïve], p < 0.001). A VA gain < 5 letters (non-response) after 2 and 4 months was seen in 18% and 16% of naïve eyes, and in 49% and 53% of non-naïve eyes (p < 0.001). A lack of anatomical response was rare in both groups, but more frequently in non-naïve eyes (12% vs. 4%, p = 0.003). Functionally and anatomically, naïve eyes showed most frequently an early and stable improvement (functionally: 77/175 44%; anatomically: 123/175 eyes, 70%). Most non-naïve eyes experienced no significant improvement functionally (97/242 eyes, 40%), despite a mostly early and stable improvement anatomical response pattern (102/242 eyes, 42%). Functional but not anatomical response patterns were influenced by baseline VA. Naïve and non-naïve eyes show different functional and anatomical response patterns to DEX implant. Functional non-responders are rare in naïve eyes, whereas anatomical non-response is unusual in both groups.Patricio J. Rodríguez-ValdésMatus RehakDinah ZurAnna Sala-PuigdollersSamantha Fraser-BellMarco LupidiJay ChhablaniZafer CebeciInês LaínsVoraporn ChaikitmongkolAdrian T. FungMali OkadaJan Darius UnterlauftLital SmadarAnat LoewensteinMatias IglickiCatharina BuschNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-8 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Patricio J. Rodríguez-Valdés Matus Rehak Dinah Zur Anna Sala-Puigdollers Samantha Fraser-Bell Marco Lupidi Jay Chhablani Zafer Cebeci Inês Laíns Voraporn Chaikitmongkol Adrian T. Fung Mali Okada Jan Darius Unterlauft Lital Smadar Anat Loewenstein Matias Iglicki Catharina Busch GRAding of functional and anatomical response to DExamethasone implant in patients with Diabetic Macular Edema: GRADE-DME Study
description	Abstract To analyze functional and anatomical response patterns to dexamethasone (DEX) implant in diabetic macular edema (DME), to describe proportion of responders and non-responders, and to propose a new DME grading system. Retrospective, multicenter, observational cohort study. Naïve and non-naïve DME patients were treated with DEX, with visual acuity (VA) ≥ 0.2 logMAR and central subfield thickness (CST) of ≥ 300 µm. Functional and anatomical responses were graded after 2 and 4 months, and categorized as early and stable improvement, early and progressive improvement, pendular response, delayed improvement, and persistent non-response. 417 eyes were included (175 treatment naïve eyes). Compared to non-naïve eyes, naïve eyes showed a very good functional response (VA gain ≥ 10 letters) more frequently after 2 and 4 months (56% and 57% [naïve] vs. 33% and 28% [non-naïve], p < 0.001). A VA gain < 5 letters (non-response) after 2 and 4 months was seen in 18% and 16% of naïve eyes, and in 49% and 53% of non-naïve eyes (p < 0.001). A lack of anatomical response was rare in both groups, but more frequently in non-naïve eyes (12% vs. 4%, p = 0.003). Functionally and anatomically, naïve eyes showed most frequently an early and stable improvement (functionally: 77/175 44%; anatomically: 123/175 eyes, 70%). Most non-naïve eyes experienced no significant improvement functionally (97/242 eyes, 40%), despite a mostly early and stable improvement anatomical response pattern (102/242 eyes, 42%). Functional but not anatomical response patterns were influenced by baseline VA. Naïve and non-naïve eyes show different functional and anatomical response patterns to DEX implant. Functional non-responders are rare in naïve eyes, whereas anatomical non-response is unusual in both groups.
format	article
author	Patricio J. Rodríguez-Valdés Matus Rehak Dinah Zur Anna Sala-Puigdollers Samantha Fraser-Bell Marco Lupidi Jay Chhablani Zafer Cebeci Inês Laíns Voraporn Chaikitmongkol Adrian T. Fung Mali Okada Jan Darius Unterlauft Lital Smadar Anat Loewenstein Matias Iglicki Catharina Busch
author_facet	Patricio J. Rodríguez-Valdés Matus Rehak Dinah Zur Anna Sala-Puigdollers Samantha Fraser-Bell Marco Lupidi Jay Chhablani Zafer Cebeci Inês Laíns Voraporn Chaikitmongkol Adrian T. Fung Mali Okada Jan Darius Unterlauft Lital Smadar Anat Loewenstein Matias Iglicki Catharina Busch
author_sort	Patricio J. Rodríguez-Valdés
title	GRAding of functional and anatomical response to DExamethasone implant in patients with Diabetic Macular Edema: GRADE-DME Study
title_short	GRAding of functional and anatomical response to DExamethasone implant in patients with Diabetic Macular Edema: GRADE-DME Study
title_full	GRAding of functional and anatomical response to DExamethasone implant in patients with Diabetic Macular Edema: GRADE-DME Study
title_fullStr	GRAding of functional and anatomical response to DExamethasone implant in patients with Diabetic Macular Edema: GRADE-DME Study
title_full_unstemmed	GRAding of functional and anatomical response to DExamethasone implant in patients with Diabetic Macular Edema: GRADE-DME Study
title_sort	grading of functional and anatomical response to dexamethasone implant in patients with diabetic macular edema: grade-dme study
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/e10c639ba77b4a99a4f809f2a0eff5c0
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GRAding of functional and anatomical response to DExamethasone implant in patients with Diabetic Macular Edema: GRADE-DME Study

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