Purpose: To report the 6-month anatomical and best-corrected visual acuity (BCVA) response after primary intravitreal dexamethasone implantation (Ozurdex®) in patients with refractory diabetic macular edema (DME). Methods: Retrospective review of the medical records of 58 patients with decreased visual acuity, due to refractory DME, who underwent a single injection of Ozurdex between November 2010 and January 2012, at the Instituto de Microcirurgia Ocular, Barcelona, Spain. Results: At baseline, the mean foveal thickness (FT) was 543.24 ± 156.51 μm. Mean (±SD) values of FT did decrease to 346.82 ± 123.74 μm at month 1 and 341.12 ± 129.64 μm at month 3. Data on the 6-month follow-up showed a mild increase to 420.16 ± 152.15 μm. All of the FT reduction outcomes were statistically significant, with respect to baseline data (p = 0.0001). The baseline BCVA data was 0.66 ± 0.36 logarithm of the minimum angle of resolution (logMAR). The mean BCVA improved to 0.52 ± 0.32 logMAR (p = 0.0001) and 0.44 ± 0.27 logMAR (p = 0.0001) after 1 and 3 months, respectively. At the last visit (6-month follow-up), the mean BCVA increased to 0.51 ± 0.31 logMAR (p = 0.0001). Conclusions: In this study, intravitreal treatment with a dexamethasone implant safely reduced DME and improved visual acuity in a difficult-to-treat patient population with long-standing refractory DME.

To compare the 6-month anatomic and best-corrected visual acuity (BCVA) response after sustained-release dexamethasone (DEX) intravitreal implant between nonvitrectomized and vitrectomized eyes with persistent diabetic macular edema (DME). Retrospective, comparative, and consecutive review of the medical records of 58 patients with decreased visual acuity, due to refractory DME, who underwent a single injection of Ozurdex between November 2010 and January 2012, at the Instituto de Microcirurgia Ocular, Barcelona, Spain. Then, we divided patients into 2 groups: 24 eyes who had undergone standard pars plana vitrectomy (vitrectomized group), and 34 eyes that were not operated on (nonvitrectomized group). Outcomes measured were BCVA and foveal thickness (FT) at baseline and at months 1, 3, and 6. Twenty-four of 58 eyes had prior vitrectomy (41%). Statistically significant improvement in BCVA also was seen at 1 month after treatment with a DEX implant and at each subsequent follow-up visit, in either groups (P<0.05). All of the FT reduction outcomes were statistically significant in both groups, with respect to baseline data (P<0.05). There were no statistically significant differences in BCVA and FT between nonvitrectomized and vitrectomized eyes at any time point (P<0.05). In this study, the clinical findings were similar between nonvitrectomized and vitrectomized eyes. Intravitreal treatment with a DEX implant safely reduced DME and improved visual acuity in both groups. No statistically significant differences were found between the 2 groups regarding FT and BCVA.

Purpose.: To evaluate the effectiveness of a single intravitreal injection of dexamethasone implant, over 6 months in patients with recalcitrant CME due to Irvine-Gass syndrome. Methods.: Retrospective review of the medical records of nine patients with refractory macular edema (ME) due to Irvine-Gass syndrome, who underwent a single intravitreal injection of dexamethasone implant, Ozurdex, between November 2010 and January 2012, at the Instituto de Microcirurgia Ocular, Barcelona, Spain. All patients underwent a complete ophthalmic evaluation, including best-corrected visual acuity (BCVA) using standardized ETDRS charts, tonometry, fluorescein angiography, and spectral-domain optical coherence tomography with foveal thickness (FT) measurement. Results.: The mean duration of CME before treatment with Ozurdex was 9.1 months (range, 6–13 months). At baseline, the mean FT was 542.22 ± 134.78 μm. Mean (SD) values of FT did decrease to 350.88 ± 98.71 μm (P = 0.001) at month 1 and 319.22 ± 60.96 μm (P = 0.002) at month 3. Data on the 6-month follow-up showed a mild increase 398.33 ± 127.89 μm (P = 0.031). The mean (SD) change from baseline FT was 191.33 μm (a decrease value of 35%) at month 1, and 223.00 μm (decrease value of 41%) and 143.89 μm (decrease value of 26%) at month 3 and month 6, respectively. The baseline BCVA data were 0.62 ± 0.15 logarithm of the minimum angle of resolution (logMAR). The mean BCVA improved to 0.47 ± 0.21 logMAR (P = 0.008) and 0.37 ± 0.24 logMAR (P = 0.001) after month 1 and month 3, respectively. At the last visit (6-month follow-up), the mean BCVA was 0.37 ± 0.26 logMAR (P = 0.002). Conclusions.: In this study, both mean FT and mean BCVA had improved from baseline by 1 month after treatment with a dexamethasone implant, and the improvement remained statistically significant throughout the 6-month study.

Purpose: To evaluate the diagnostic accuracy of a diagnostic system software for the automated screening of diabetic retinopathy (DR) on digital colour fundus photographs, the 2019 Convolutional Neural Network (CNN) model with Inception-V3. Methods: In this cross-sectional study, 295 fundus images were analysed by the CNN model and compared to a panel of ophthalmologists. Images were obtained from a dataset acquired within a screening programme. Diagnostic accuracy measures and respective 95% CI were calculated. Results: The sensitivity and specificity of the CNN model in diagnosing referable DR was 81% (95% CI 66–90%) and 97% (95% CI 95–99%), respectively. Positive predictive value was 86% (95% CI 72–94%) and negative predictive value 96% (95% CI 93–98%). The positive likelihood ratio was 33 (95% CI 15–75) and the negative was 0.20 (95% CI 0.11–0.35). Its clinical impact is demonstrated by the change observed in the pre-test probability of referable DR (assuming a prevalence of 16%) to a post-test probability for a positive test result of 86% and for a negative test result of 4%. Conclusion: A CNN model negative test result safely excludes DR, and its use may significantly reduce the burden of ophthalmologists at reading centres.