First Author: E.Dogan TURKEY
Co Author(s): B. Cakir E. Celik T. Ucak G. Alagoz
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To evaluate the effects of repeated intravitreal dexamethasone implant (Ozurdex®) for the treatment of diabetic macular edema (DME) resistant to consecutive ranibizumab injections.
Thirty four eyes of 24 (10 male, 14 female) patients who received more than 1 Ozurdex® injections for ranibizumab-resistant macular edema secondary to diabetes were included this retrospective study. DME considered resistant to ranibizumab if central macular thickness (CMT) was > 250 µ after at least three consecutive monthly injections. The demographic data, visual acuity (VA), central macular thickness (CMT), number of injections, time to reinjections and occurance of any complications were reviewed.
Nine (37.5%) patients had proliferative diabetic retinopathy and the mean duration of diabetes was 12.32±4.53 (4-29) years. The number of previous injections of ranibizumab was 5.38±1.53 (3-9). Mean interval for Ozurdex® reinjection was 6.12±1.16 months following the first injection (34 of 34 eyes), 5.78±0.80 months following the second (3 of 34 eyes). At baseline the mean VA was 0.85±0.37 LogMAR and it significantly improved to 0.76±0.36 LogMAR after first Ozurdex® injection (p<0.05). Before the second and third Ozurdex® injection the mean VA was 0.95±0.36 LogMAR and 1.4±0.4 LogMAR respectively. It improved to 0.82±0.36 LogMAR and 0.9±0.1 respectively (p:0.00, p:0.154). Mean baseline CMT was 532.08±103.02 µ and it decreased to 319.08±72.5 µ after first Ozurdex® injection (p<0.05). Before the second and third Ozurdex® injection CMT was 571.7±161.3, 604.0±280.7 µ and it decreased to 358.5±82.2, 279.3±89.5 µ respectively (p:0.00, p:0.100). No serious complication was observed during follow up; 1 eye developed cataract and 7 eyes developed transient intraocular pressure increase.
Repeated injections of Ozurdex® seem safe and effective treatment for persistent DME in patients resistant to consecutive ranibizumab injections.