Posters

Intravitreal steroids in the treatment of diabetic macular edema: Clinical outcomes and safety

Poster Details

First Author: R.Bourkiza UK

Co Author(s):    D. Edison   R. Ranjendram   R. Hamilton                       

Abstract Details



Purpose:

To assess the clinical outcome and safety of intravitreal steroids (Ozurdex® and triamcinolone) in the treatment of diabetic macular edema (DME)

Setting:

Outpatient injection units across 4 sites of Moorfields Eye Hospital, a UK National Health Service clinical setting.

Methods:

Retrospective analysis of electronic medical record (EMR) notes and paper case notes, and review of optical coherence tomography (OCT) imaging of consecutive patients treated with intravitreal Ozurdex® and triamcinolone for DME between July 2015 and December 2016. Data was collected on age, gender, ocular co-morbidity, previous treatment, intraoperative complications, ETDRS visual acuity (VA), and OCT Central Macular Thickness (CMT) prior to injection and at 1/12, 3/12 and 6/12 post-injection, high intra-ocular pressure (IOP) and treatment. High IOP was defined as IOP>21mmhg.

Results:

37 patients had full data (23 male; 14 female). Mean age was 65 (44-85). A total of 43 injections were performed between November 2015 and December 2016, of which 39 were first injection episodes (27 Ozurdex®; 12 Triamcinolone). Mean follow-up was 7.42 months (1-17 months). Mean baseline VA was 57.65 letters. Mean baseline CMT was 391.05 μm. At one month, mean change in VA was +3.97 letters (p<0.05), and mean change in CMT was -79.79 μm (p<0.05). At 3-month follow up, mean change in VA was +2.46 letters (p =0.054), and mean change in CMT was -89.32 μm (p<0.05). At 6 months, these were +1.17 letters (p= 0.27) and -48.88 μm (p<0.05) respectively. 6 cases (16.2%) required re-treatment with the same agent (5 after Ozurdex® and 1 after Triamcinolone) at a mean interval of 6 months (3-10 months) 7 patients (18.9%) required subsequent treatment in the form of Lucentis or Eylea® and 3 (8.1%) required Iluvien® implant. 7 patients (18.9%) had high IOP at any time point after injection. All 7 required treatment (medical, none required glaucoma surgery).

Conclusions:

Although there was a statistically significant improvement in the OCT Central Macular Thickness at all follow-up intervals after intravitreal steroids for DME, the change in visual acuity was not significant, and more than a third of cases required subsequent treatment. High IOP occurred in less than a fifth of patients and responded to medical treatment.

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