Purpose: To assess the clinical significance of suspended scattering particles in motion (SSPiM) and different cystic phenotypes in diabetic macular oedema (DME) treated with dexamethasone implant (DEX-i). Methods: A retrospective review of type 2 diabetic patients with DME treated with a DEX-i was conducted. Swept-source optical coherence tomography angiography (OCTA, PLEX Elite 9000) with a 3-mm volume cube was performed. Regions of interest were delineated with Fiji software (version 2.1.0/1.53.c) in the superficial vascular complex (SVC) and deep capillary plexus (DCP) at baseline, 2- and 4-months after DEX-i. SSPiM was defined as regions of variable reflectivity with a decorrelation signal. Without a detectable decorrelation signal, its counterpart was addressed as ‘corpuscular,’ while hyporeflective cysts were optical empty without hyperreflective material enclosed. Results: After treatment, the hyporeflective component demonstrated substantial reabsorption in the SVC (–95.4% at 2- and –84.4% at 4-months, p < 0.01 both) and DVC (–84.4%, 2-months), with a less critical decrease of the corpuscular component in the SVC (2-months: –41.9%, p = 0.001 and 4 months: –1.8%, p = 0.73), and not significant in the DVC. SSPiM did not significantly change in the SVC and DVC neither at 2- and 4-months (p > 0.05, all). Conclusions: After a single DEX-i, the clearance of different cystic phenotypes proceeds with resorption of hyporeflective, followed by corpuscular components. SSPiM demonstrated minimal response, indicating a severe BRB breakdown that may require repeated treatment to reach a satisfactory anatomical response.
Differences in cysts characteristics and related influence on the anatomical response after dexamethasone implant in diabetic macular oedema / Parravano, M.; Fragiotta, S.; Costanzo, E.; Giannini, D.; De Geronimo, D.; Viggiano, P.; Riccardo, S.; Querques, G.. - In: EYE. - ISSN 0950-222X. - 36:6(2022), pp. 1329-1331. [10.1038/s41433-021-01857-8]
Differences in cysts characteristics and related influence on the anatomical response after dexamethasone implant in diabetic macular oedema
Fragiotta S.;De Geronimo D.;
2022
Abstract
Purpose: To assess the clinical significance of suspended scattering particles in motion (SSPiM) and different cystic phenotypes in diabetic macular oedema (DME) treated with dexamethasone implant (DEX-i). Methods: A retrospective review of type 2 diabetic patients with DME treated with a DEX-i was conducted. Swept-source optical coherence tomography angiography (OCTA, PLEX Elite 9000) with a 3-mm volume cube was performed. Regions of interest were delineated with Fiji software (version 2.1.0/1.53.c) in the superficial vascular complex (SVC) and deep capillary plexus (DCP) at baseline, 2- and 4-months after DEX-i. SSPiM was defined as regions of variable reflectivity with a decorrelation signal. Without a detectable decorrelation signal, its counterpart was addressed as ‘corpuscular,’ while hyporeflective cysts were optical empty without hyperreflective material enclosed. Results: After treatment, the hyporeflective component demonstrated substantial reabsorption in the SVC (–95.4% at 2- and –84.4% at 4-months, p < 0.01 both) and DVC (–84.4%, 2-months), with a less critical decrease of the corpuscular component in the SVC (2-months: –41.9%, p = 0.001 and 4 months: –1.8%, p = 0.73), and not significant in the DVC. SSPiM did not significantly change in the SVC and DVC neither at 2- and 4-months (p > 0.05, all). Conclusions: After a single DEX-i, the clearance of different cystic phenotypes proceeds with resorption of hyporeflective, followed by corpuscular components. SSPiM demonstrated minimal response, indicating a severe BRB breakdown that may require repeated treatment to reach a satisfactory anatomical response.File | Dimensione | Formato | |
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