First Author: M.Ozturk TURKEY
Co Author(s): F. Onder
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This study aimed to evaluate the intravitreal dexamethasone implant (DEX implant) treatment in our patients with diabetic macular edema and report the results in our real life practice.
Haseki Training and Research Hospital
The charts of the patients with diabetic macular edema which had taken intravitreal DEX implant treatment were retrospectively reviewed and 40 eyes of 32 patients which had at least 1 year follow up period after the first intravitreal DEX implant were included in the study. Demographic properties of the patients, previous ocular treatments, ophthalmic examination findings, optical coherence tomography findings taken before and after intravitreal DEX implant treatment and details and results of the treatment were evaluated.
Of the studied patients 19 were male and 13 were female. The mean age of the patients was 62.9±8.8 years and the mean duration of diabetes mellitus was 16.5±8.5 years. For 8 patients, unilateral and for 24 patients, bilateral intravitreal DEX implant treatment was performed. While 38 eyes had been taken previous treatments (28 eyes panretinal photocoagulation, 22 eyes focal laser, 22 eyes intravitreal triamsinolone and anti-VEGF injections, 16 eyes only intravitreal anti-VEGF injection) 2 eyes were untreated. The mean duration of follow up was 14.9±3.8 (12-24) months and the mean number of intravitreal DEX implants performed was 2.5±1.1 within that period. The main duration of treatment-free period was 6.45±4 months. Additional intravitreal ranibizumab injection treatment was performed in 15 eyes and the mean number of injection was 2.07±1.43. Additional focal laser treatment was performed in 3 eyes. Baseline and final intraocular pressures were 14.7±2.2 mmHg and 15.5±1.6 mmHg respectively (p=0.007) but galucoma surgery was not needed in any eye. Cataract surgery was performed in one eye. Baseline best-corrected visual acuity was 0.85±0.32 LogMAR; it significantly improved to 0.56±0.33 LogMAR (p˂0.001). Central macular thickness decreased from 566.53±153.19 µm (baseline) to 244.45±50.27 µm (p˂0.001).
Although intravitreal DEX implant treatment is a very effective treatment option in diabetic macular edema, patient selection is very important. Even though intravitreal DEX implant treatment was planned as the main treatment regimen, during the treatment period, anti-VEGF shifts should be kept in mind in risky patients like one eyed ones or the ones with increased intraocular pressures.