First Author: M.Dogan TURKEY
Co Author(s): M. Sabaner
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To investigate the effect of intravitreal dexamethasone implant injections in patients with persistent diabetic macular edema who were previously injected with multiple intravitreal ranibizumab.
Afyon Kocatepe University Faculty of Medicine, Department of Ophthalmology, Afyonkarahisar, Turkey
Thirty-six eyes of 24 patients with persistent diabetic macular edema were enrolled to this retrospective study. Patients, poor-responded to previous ranibizumab treatment, were switched to intravitreal dexamethasone implant therapy. Each patient was injected one dose intravitreal dexamethasone implant and examined first, second and third months after. Best-corrected visual acuity (BCVA), intraocular pressure (IOP) and spectral domain-optical coherence tomography (SD-OCT) findings such as central macular thickness (CMT), total macular volume (TMV), central subfield volume (CSV) and choroidal thickness (CT) were evaluated.
The mean age was 64.28±8.60 years. The number of individuals of each sex was equal. 21 (%58) eyes were pseudophakic, 15 (%42) were phakic. During before the switch, patients received a mean of 6.33±1.22 ranibizumab injections. Mean BCVA at baseline was 0.96±0.62 LogMAR. It changed to 0.94±0.63 LogMAR (p=0.881) during switch and 0.89±0.64 LogMAR (p=0.666) at one month after switch. Mean CMT at baseline was 572.36±291.70 µm. It changed to 491.22±228.95 µm (p=0.200) during switch and 223.69±69.65 µm (p<0.001) at one month after switch. Mean TMV at baseline was 11.81±3.21 mm3. It changed to 11.18±2.36 mm3 (p=0.355) during switch and 8.76±0.96 mm3 (p<0.001) at one month after switch. Mean CSV at baseline was 0.44±0.20 mm3. It changed to 0.39±0.14 mm3 (p=0.195) during switch and 0.21±0.04 mm3 (p<0.001) at one month after switch. Mean CT at baseline was 177.00±27.50 µm. It changed to 176.39±27.37 µm (p=0.896) during switch and 176.11±28.15 µm (p=0.864) at one month after switch.
Intravitreal dexamethasone implant is effective in treatment of persistent diabetic macular edema with anti-VEGF therapy. Intravitreal dexamethasone implant could be considered as part of therapy in those patients.