Differences in cysts characteristics and related influence on the anatomical response after dexamethasone implant in diabetic macular oedema.

Mariacristina Parravano, Serena Fragiotta, Eliana Costanzo, Daniela Giannini, Daniele De Geronimo, Pasquale Viggiano, Sacconi Riccardo, Giuseppe Querques

Eye (London, England) 2022 Jun

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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). 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. 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). 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. © 2021. The Author(s), under exclusive licence to The Royal College of Ophthalmologists.

Citation

Mariacristina Parravano, Serena Fragiotta, Eliana Costanzo, Daniela Giannini, Daniele De Geronimo, Pasquale Viggiano, Sacconi Riccardo, Giuseppe Querques. Differences in cysts characteristics and related influence on the anatomical response after dexamethasone implant in diabetic macular oedema. Eye (London, England). 2022 Jun;36(6):1329-1331