First Author: K.Klabe GERMANY
Co Author(s): A. Fricke C. Ullmann G. Auffarth D. Breyer R. Fulga H. Kaymak
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We evaluated the efficacy of intravitreal dexamethasone implant for the treatment of diabetic macular edema (DME) in nonglaucomatous eyes over a follow-up period up to 120 days in subgroup of native versus non-native patients.
Internationale Innovative Ophthalmochirurgie Düsseldorf, Germany; International Vision Correction Research Network, Germany
This was a retrospective observation. Patients with persistent DME who were phakic or pseudophakic and did not have a glaucoma or ocular hypertension history were included. After an initial administration of dexamethasone changes in best-corrected visual acuity (BCVA), central subfield thickness (CST), intraocular pressure (IOP) (Cirrus HD-OCT; Zeiss) were evaluated.
The study included 68 eyes, 38 eyes were treated with dexamethasone in first line therapy. For both subgroups summarized the mean BCVA at baseline and at weeks 1, 6, and 12 were 0.45 ± 0.3, 0.5 ± 0.38, 0.6 ± 0.3 and 0.35 ± 0.3 LogMAR, respectively. Mean CST at baseline and at weeks 1, 6, and 12 were 394 ± 153 μm, 262 ± 125 μm, 261 ± 56 μm and 307 ± 122 μm, respectively. 14% showed an increase in IOP of ≥10 mmHg and three of them needed antiglaucoma medication.
In nonglaucomatous eyes with DME, intravitreal dexamethasone implant was found to be beneficial in regard to visual and anatomic success and seemed safe in this selected group of patients. Inside this group the treatment of the DME with dexamethasone in first-line therapy is not inferior to the second-line therapy! Therefore, it can be an advantage to treat selected patients (anxiety patients or cardiovascular risk disorders) with this alternative therapy option.