TY - JOUR
T1 - Foveal Eversion
T2 - A Possible Biomarker of Persistent Diabetic Macular Edema
AU - Arrigo, Alessandro
AU - Aragona, Emanuela
AU - Capone, Luigi
AU - Lattanzio, Rosangela
AU - Zollet, Piero
AU - Bandello, Francesco
N1 - Funding Information:
We thank the participants of the study. No funding or sponsorship was received for this study or publication of this article. The Rapid Service Fee was funded by the authors. All named authors meet the International Committee of Medical Journal Editors (ICMJE) criteria for authorship for this article, take responsibility for the integrity of the work as a whole, and have given their approval for this version to be published. Francesco Bandello: consultant for Alcon (Fort Worth, TX, USA), Alimera Sciences (Alpharetta, GA, USA), Allergan Inc. (Irvine, CA, USA), Farmila-Thea (Clermont-Ferrand, France), Bayer Shering-Pharma (Berlin, Germany), Bausch And Lomb (Rochester, NY, USA), Genentech (San Francisco, CA, USA), Hoffmann-La-Roche (Basel, Switzerland), NovagaliPharma (?vry, France), Novartis (Basel, Switzerland), Sanofi-Aventis (Paris, France), Thrombogenics (Heverlee, Belgium) and Zeiss (Dublin, CA, USA). Alessandro Arrigo, Emanuela Aragona, Luigi Capone, Rosangela Lattanzio and Piero Zollet have nothing to disclose. The study was designed as prospective, cohort study involving DME patients followed at the Department of Ophthalmology, San Raffaele Hospital, Milan, Italy. The study was approved by the Ethics Committee of San Raffaele Hospital, Milan, Italy, and was conducted in accordance with Helsinki Declaration. We obtained signed informed consent from all the patients before inclusion into the study. Data sharing is not applicable to this article as no datasets were generated or analyzed during the current study.
Publisher Copyright:
© 2021, The Author(s).
PY - 2021/3
Y1 - 2021/3
N2 - Introduction: We aimed to evaluate the impact of foveal eversion on treatment response and persistent diabetic macular edema (DME). Methods: The study was designed as interventional and prospective. DME eyes were treated with ranibizumab and/or dexamethasone (DEX) implants, or with fluocinolone acetonide (FAc) implants. FAc-treated eyes were eventually retreated by additional ranibizumab injections. Main outcome measure was the relationship between foveal eversion and both clinical outcome and persistent DME. Results: Sixty-eight DME eyes (68 patients) treated by anti-VEGF/DEX and 50 FAc-treated eyes (50 patients) were recruited. The follow-up was 16 ± 3 months. The anti-VEGF/DEX group and FAc-treated group were statistically matched for age, sex, DME duration and previous number of injections (p > 0.05). Both groups experienced statistically significant improvements of both BCVA and central macular thickness (p < 0.01) at the end of the follow-up. Persistent DME was shown by 46% of anti-VEGF/DEX eyes and 42% of FAc-treated eyes. Foveal eversion was found in 50% of anti-VEGF/DEX eyes and in 44% of FAc-treated eyes. Its presence was associated with worse anatomical and visual outcome and higher persistence of DME in both groups (p < 0.01) and with higher retreatment percentages in FAc-treated eyes (p < 0.01). Conclusion: Foveal eversion is associated with worse clinical and morphological outcomes in DME.
AB - Introduction: We aimed to evaluate the impact of foveal eversion on treatment response and persistent diabetic macular edema (DME). Methods: The study was designed as interventional and prospective. DME eyes were treated with ranibizumab and/or dexamethasone (DEX) implants, or with fluocinolone acetonide (FAc) implants. FAc-treated eyes were eventually retreated by additional ranibizumab injections. Main outcome measure was the relationship between foveal eversion and both clinical outcome and persistent DME. Results: Sixty-eight DME eyes (68 patients) treated by anti-VEGF/DEX and 50 FAc-treated eyes (50 patients) were recruited. The follow-up was 16 ± 3 months. The anti-VEGF/DEX group and FAc-treated group were statistically matched for age, sex, DME duration and previous number of injections (p > 0.05). Both groups experienced statistically significant improvements of both BCVA and central macular thickness (p < 0.01) at the end of the follow-up. Persistent DME was shown by 46% of anti-VEGF/DEX eyes and 42% of FAc-treated eyes. Foveal eversion was found in 50% of anti-VEGF/DEX eyes and in 44% of FAc-treated eyes. Its presence was associated with worse anatomical and visual outcome and higher persistence of DME in both groups (p < 0.01) and with higher retreatment percentages in FAc-treated eyes (p < 0.01). Conclusion: Foveal eversion is associated with worse clinical and morphological outcomes in DME.
KW - Anti-VEGF
KW - Dexamethasone implant
KW - Diabetic macular edema
KW - Fluocinolone acetonide
KW - Foveal eversion
KW - OCT
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U2 - 10.1007/s40123-020-00324-z
DO - 10.1007/s40123-020-00324-z
M3 - Article
AN - SCOPUS:85098947723
SN - 2193-8245
VL - 10
SP - 115
EP - 126
JO - Ophthalmology and Therapy
JF - Ophthalmology and Therapy
IS - 1
ER -