TY - JOUR
T1 - Intravitreal fluocinolone acetonide may decelerate diabetic retinal neurodegeneration
AU - Lynch, Stephanie K.
AU - Lee, Kyungmoo
AU - Chen, Zhi
AU - Folk, James C.
AU - Schmidt-Erfurth, Ursula
AU - Gerendas, Bianca S.
AU - Wahle, Andreas
AU - Wykoff, Charles C.
AU - Abràmoff, Michael D.
N1 - Funding Information:
Supported by the Arnold and Mabel Beckman Initiative for Macular Research; the following National Eye Institute grants: R01 EY019112, R01 EY018853, and R01 EY17066; the Veterans Administration I01 CX000119; and Alimera Sciences, Inc. (Atlanta, GA, USA). Disclosure: S.K. Lynch, None; K. Lee, None; Z. Chen, None; J.C. Folk, IDx (I, S); U. Schmidt-Erfurth, IDx (C); B.S. Gerendas, IDx (F, C); A. Wahle, None; C.C. Wykoff, IDx (F, C, S); M.D. Abramoff, IDx (F, C, I, E, S), P
Publisher Copyright:
© 2019 The Authors.
PY - 2019/5
Y1 - 2019/5
N2 - PURPOSE. There is no prevention or treatment for diabetic retinal neurodegeneration (DRN), which is a complication of diabetes that can occur independently of diabetic retinopathy (DR). We hypothesized that an intravitreal fluocinolone acetonide (FAc) implant may affect the rate of DRN when used in patients with diabetic macular edema (DME). METHODS. In this retrospective analysis, optical coherence tomography with neuroretinal analysis was obtained at 3-month intervals from 130 patients in the USER study both before (mean duration 903 days, range 35-4005 days) and after administration of FAc (mean 408 days, range 7 to 756 days). The rate of DRN was defined as the change over time on inner neuroretinal thickness using logistic regression. A DRN rate was calculated independently for two areas: region 1 located within 1.5 mm of the fovea, and region 2 from 1.5 mm to 3.0 mm from the fovea. RESULTS. In regions of the macula more than 1.5 mm from the central fovea, there was a statistically significant decrease in the rate of DRN in the post-FAc period. The pre-FAc neuroretinal loss in this area occurred at 4.0 µm/y, compared with a post-FAc loss rate of 1.1 µm/y (P = 0.001). CONCLUSIONS. This retrospective study suggests that FAc may decelerate the rate of inner retinal thinning in patients with persistent DME. Further prospective studies are necessary to determine the effects of FAc on the rate of DRN in patients with DME.
AB - PURPOSE. There is no prevention or treatment for diabetic retinal neurodegeneration (DRN), which is a complication of diabetes that can occur independently of diabetic retinopathy (DR). We hypothesized that an intravitreal fluocinolone acetonide (FAc) implant may affect the rate of DRN when used in patients with diabetic macular edema (DME). METHODS. In this retrospective analysis, optical coherence tomography with neuroretinal analysis was obtained at 3-month intervals from 130 patients in the USER study both before (mean duration 903 days, range 35-4005 days) and after administration of FAc (mean 408 days, range 7 to 756 days). The rate of DRN was defined as the change over time on inner neuroretinal thickness using logistic regression. A DRN rate was calculated independently for two areas: region 1 located within 1.5 mm of the fovea, and region 2 from 1.5 mm to 3.0 mm from the fovea. RESULTS. In regions of the macula more than 1.5 mm from the central fovea, there was a statistically significant decrease in the rate of DRN in the post-FAc period. The pre-FAc neuroretinal loss in this area occurred at 4.0 µm/y, compared with a post-FAc loss rate of 1.1 µm/y (P = 0.001). CONCLUSIONS. This retrospective study suggests that FAc may decelerate the rate of inner retinal thinning in patients with persistent DME. Further prospective studies are necessary to determine the effects of FAc on the rate of DRN in patients with DME.
KW - Diabetic neuroretinal degeneration
KW - Fluocinolone acetonide (FAC) implant
KW - Ganglion cell layer
KW - Inner plexiform layer
KW - Nerve fiber layer
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U2 - 10.1167/iovs.18-24643
DO - 10.1167/iovs.18-24643
M3 - Article
C2 - 31100106
AN - SCOPUS:85066238619
VL - 60
SP - 2134
EP - 2139
JO - Investigative Ophthalmology and Visual Science
JF - Investigative Ophthalmology and Visual Science
SN - 0146-0404
IS - 6
ER -