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Article: Real-world assessment of intravitreal dexamethasone implant (0.7 mg) in patients with macular edema: The CHROME study

TitleReal-world assessment of intravitreal dexamethasone implant (0.7 mg) in patients with macular edema: The CHROME study
Authors
KeywordsDiabetic macular edema
Issue Date2015
Citation
Clinical Ophthalmology, 2015, v. 9, p. 1255-1268 How to Cite?
Abstract© 2015 Lam et al.Background: The purpose of this study was to evaluate the real-world use, efficacy, and safety of one or more dexamethasone intravitreal implant(s) 0.7 mg (DEX implant) in patients with macular edema (ME). Methods: This was a retrospective cohort study of patients with ME secondary to retinal disease treated at ten Canadian retina practices, including one uveitis center. Best-corrected visual acuity (BCVA), central retinal thickness (CRT), intraocular pressure (IOP), glaucoma and cataract surgery, and safety data were collected from the medical charts of patients with ≥3 months of follow-up after the initial DEX implant.Results: One hundred and one patient charts yielded data on 120 study eyes, including diagnoses of diabetic ME (DME) (n=34), retinal vein occlusion (RVO, n=30; branch in 19 and central in 11), and uveitis (n=23). Patients had a mean age of 60.9 years, and 73.3% of the study eyes had ME for a duration of ≥12 months prior to DEX implant injection(s). Baseline mean (± standard error) BCVA was 0.63±0.03 logMAR (20/86 Snellen equivalents) and mean CRT was 474.4±18.2 μm. The mean number of DEX implant injections was 1.7±0.1 in all study eyes; 44.2% of eyes had repeat DEX implant injections (reinjection interval 2.3–4.9 months). The greatest mean peak changes in BCVA lines of vision occurred in study eyes with uveitis (3.3±0.6, P<0.0001), followed by RVO (1.3±0.5, P<0.01) and DME (0.7±0.5, P>0.05). Significant decreases in CRT were observed: -255.6±43.6 µm for uveitis, -190.9±23.5 µm for DME, and -160.7±39.6 µm for RVO (P<0.0001 for all cohorts). IOP increases of ≥10 mmHg occurred in 20.6%, 24.1%, and 22.7% of DME, RVO, and uveitis study eyes, respectively. IOP-lowering medication was initiated in 29.4%, 16.7%, and 8.7% of DME, RVO, and uveitis study eyes, respectively. Glaucoma surgery was performed in 1.7% of all study eyes and cataract surgery in 29.8% of all phakic study eyes receiving DEX implant(s). onclusion: DEX implant(s) alone or combined with other treatments and/or procedures resulted in functional and anatomic improvements in long-standing ME associated with retinal disease.
Persistent Identifierhttp://hdl.handle.net/10722/228223
ISSN
2015 SCImago Journal Rankings: 0.787

 

DC FieldValueLanguage
dc.contributor.authorLam, Wai Ching-
dc.contributor.authorAlbiani, David A.-
dc.contributor.authorYoganathan, Pradeepa-
dc.contributor.authorChen, John Chanchiang-
dc.contributor.authorKherani, Amin-
dc.contributor.authorMaberley, David A L-
dc.contributor.authorOliver, Alejandro-
dc.contributor.authorRabinovitch, Theodore-
dc.contributor.authorSheidow, Thomas G.-
dc.contributor.authorTourville, Eric-
dc.contributor.authorWittenberg, Leah A.-
dc.contributor.authorSigouin, Chris-
dc.contributor.authorBaptiste, Darryl C.-
dc.date.accessioned2016-08-01T06:45:30Z-
dc.date.available2016-08-01T06:45:30Z-
dc.date.issued2015-
dc.identifier.citationClinical Ophthalmology, 2015, v. 9, p. 1255-1268-
dc.identifier.issn1177-5467-
dc.identifier.urihttp://hdl.handle.net/10722/228223-
dc.description.abstract© 2015 Lam et al.Background: The purpose of this study was to evaluate the real-world use, efficacy, and safety of one or more dexamethasone intravitreal implant(s) 0.7 mg (DEX implant) in patients with macular edema (ME). Methods: This was a retrospective cohort study of patients with ME secondary to retinal disease treated at ten Canadian retina practices, including one uveitis center. Best-corrected visual acuity (BCVA), central retinal thickness (CRT), intraocular pressure (IOP), glaucoma and cataract surgery, and safety data were collected from the medical charts of patients with ≥3 months of follow-up after the initial DEX implant.Results: One hundred and one patient charts yielded data on 120 study eyes, including diagnoses of diabetic ME (DME) (n=34), retinal vein occlusion (RVO, n=30; branch in 19 and central in 11), and uveitis (n=23). Patients had a mean age of 60.9 years, and 73.3% of the study eyes had ME for a duration of ≥12 months prior to DEX implant injection(s). Baseline mean (± standard error) BCVA was 0.63±0.03 logMAR (20/86 Snellen equivalents) and mean CRT was 474.4±18.2 μm. The mean number of DEX implant injections was 1.7±0.1 in all study eyes; 44.2% of eyes had repeat DEX implant injections (reinjection interval 2.3–4.9 months). The greatest mean peak changes in BCVA lines of vision occurred in study eyes with uveitis (3.3±0.6, P<0.0001), followed by RVO (1.3±0.5, P<0.01) and DME (0.7±0.5, P>0.05). Significant decreases in CRT were observed: -255.6±43.6 µm for uveitis, -190.9±23.5 µm for DME, and -160.7±39.6 µm for RVO (P<0.0001 for all cohorts). IOP increases of ≥10 mmHg occurred in 20.6%, 24.1%, and 22.7% of DME, RVO, and uveitis study eyes, respectively. IOP-lowering medication was initiated in 29.4%, 16.7%, and 8.7% of DME, RVO, and uveitis study eyes, respectively. Glaucoma surgery was performed in 1.7% of all study eyes and cataract surgery in 29.8% of all phakic study eyes receiving DEX implant(s). onclusion: DEX implant(s) alone or combined with other treatments and/or procedures resulted in functional and anatomic improvements in long-standing ME associated with retinal disease.-
dc.languageeng-
dc.relation.ispartofClinical Ophthalmology-
dc.subjectDiabetic macular edema-
dc.titleReal-world assessment of intravitreal dexamethasone implant (0.7 mg) in patients with macular edema: The CHROME study-
dc.typeArticle-
dc.description.natureLink_to_subscribed_fulltext-
dc.identifier.doi10.2147/OPTH.S80500-
dc.identifier.scopuseid_2-s2.0-84937709345-
dc.identifier.volume9-
dc.identifier.spage1255-
dc.identifier.epage1268-
dc.identifier.eissn1177-5483-

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