First Author: N.Unlu TURKEY
Co Author(s): G. Uney M. Acar D. Hazirolan R. Yalcin F. Ornek
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To evaluate the efficacy of intravitreal dexamethasone injections in diabetic macular edema (DME).
Ankara Training and Research Hospital
A 700 μg slow-release intravitreal dexamethasone implant (Ozurdex®) was placed in the vitreal cavity of 21 patients (24 eyes) affected with persistent DME. Best corrected visual acuity (BCVA) was measured with Snellen chart. Central macular thickness (CMT) was measured by spectral-domain optical coherence tomography. BCVA and CMT examinations were carried out at baseline (T0) and repeated after one month (T1), three months (T3), six months (T6) and last follow-up (TL) post injection.
The mean age of patients was 60.6 ±4,7 years and 13 (61.9%) were female. The mean follow-up was 18.4 ± 12.9 months. The mean number of anti-VEGF injection was 4.1±1.5. After dexamethasone implant treatment mean visual acuity at baseline improved from 0.79 ± 0.35 LogMAR (20/123 Snellen equivalent) to 0.64 ± 0.33 LogMAR (20/88) at month 1 (p<0,005), 0.64 ± 0.34 LogMAR (20/88) at month 3 (p=0.012), 0.64 ± 0.32 LogMAR (20/88) at month 6 (p=0.005) and 0.66±0.42 (20/91) at the last follow-up visit (p=0.11) The central macular thickness decreased from 486.7 ±109.4 μm to 320.8 ± 109.4 μm at month 1 (P < 0.001), 340.9 ± 101.8 μm at month 3 (P < 0.001), 421.5 ± 112.8 μm at month 6 (P=0.46), and 365.2 ± 115.1 μm at last follow-up (P< 0.001). Twenty percent of eyes developed a transient increase in intraocular pressure (IOP ≥ 25 mmHg), and cataract was removed from 30.7% of phakic eyes.
Intravitreal dexamethasone implant is a good option to improve visual acuity and central macular thickness in DME patients resistant to anti-VEGF therapy in short term. In long term although the anatomical improvement continues the visual acuity enhancement is not preserved.