Session Title: Quick Fire Free Paper Session 02
Session Date/Time: Thursday 26/09/2013 | 14:30-16:00
Paper Time: 15:10
Venue: Hall G1 (Level 2)
First Author: M.Lafuente SPAIN
Co Author(s): L. Ort M. Argente J. Guindo S. Mayor
To evaluate the efficacy of a single intravitreal Dexamethasone implant (IDI) over 6 and 9 months in eyes with diabetic macular edema (DME) that do not respond to standard treatments.
Prospective interventional study. Nine months follow up.
In this study, 20 eyes of 15 patients (10 males, 5 females; mean age 66 years) with Type 2 diabetes and decreased visual acuity due to persistent DME, despite of previous treatments with laser and / or at last three intravitreal injections of anti-vascular endothelial growth factor (VEGF), were treated with a single injection of IDI. Mean outcome measures included changes in best-corrected visual acuity (BCVA) and Central retinal thickness (CRT) at 6 and 9 months. The median follow-up was 6 months for the 20 eyes and 9 months for 11 eyes.
20 eyes with persistent DME were included. All patients had undergone previous treatments for DME (with laser photocoagulation or intravitreal injection of anti-VEGF). At baseline, the mean BCVA was 0.85 ±0.34 logMAR, and the mean CRT was, 562±100.3 µm. The mean BCVA improved to 0.69±0.26 logMAR after the first month. Improvement was maintained until the sixth month (mean BCVA, 0.71±0.28 log MAR; p=0.001). The BCVA decreased to 0.77±0.36 logMAR on the seventh month and to 0.8±0.34log MAR (p<0.05) on the ninth month. 40% of patients improved more than 15 letters at month three, this percentage decreased to 25% at month sixth. The mean CRT decreased to 271±53µm (p<0.05) after the first month, but increased again to 434±148µm and 479±161µm; p>0.05, at 4 and 6 months of follow up. Thickness keeps on increased in 75% of patients to 9 month of follow up. All of them needed retreatments. 25% of patients maintained stable values at 9 month of follow up. The mean intraocular pressure was 17,4±4 mmHg, only one patients developed a transient intraocular pressure increase 2 month after the injection but was treated successfully with topical medication. This medication could stop at month 6.
Intravitreal implant of Dexamethasone seems effective in the short term for the treatment of diabetic patients with refractory DME. 25% of patients maintained stable values of VA and macular thickness until the 9 month of follow up. This study need more follow-up to know the long term results.