Session Title: Quick Fire Free Paper Session 04
Session Date/Time: Sunday 29/09/2013 | 11:00-13:00
Paper Time: 12:20
Venue: Hall C (Level 1)
First Author: J.Giralt SPAIN
Co Author(s): M. Latasiewicz C. Fontecilla M. Alforja M. Navarro
To evaluate the effects of intravitreal dexamethasone implant (IDI) (Ozurdex®) for the treatment of diabetic macular edema (ME) refractory to other conventional treatments.
Hospital Clinic of Barcelona, Spain (Tertiary referral center in Spain)
Charts of patients with persistent diabetic ME treated with IDI at Hospital Clinic of Barcelona were reviewed. All patients had an inadequate control of ME despite having been treated with different therapies. The main outcome measure was reduction in central retinal thickness (CRT). Secondary outcomes were: improvement in BCVA and retreatment interval. Tolerability of the implant was also assessed.
Thirty three eyes of 32 patients were included in the analysis. Mean postoperative follow-up was 6.7 months (3-23 range). The mean baseline CRT was 496.6 μm which had decreased to 294.7 μm at 3 months (p<0.0001) and then reached 356.9 μm at 6 months (p= 0.0015). At three months the Best Corrected Visual Acuity (BCVA) had improved 2 or more optotype lines in 11 eyes, had remained stable in 18 eyes and had worsened in 4 eyes (p=0.068). At six months the BCVA had improved in 4 eyes, stabilized in 10 eyes and worsened in 1 eye (p=0.0001). Relapse of ME occurred in 50% of the eyes by the fifth month. Four eyes received a second IDI. An increase in intraocular pressure (IOP) of 10 mmHg or more was recorded in 21.9% of eyes. During the study period cataract surgery was performed in 3 eyes and progression of cataract was observed in 1 eye.
Intravitreal dexamethasone implant seems to be a safe and effective treatment for patients with refractory diabetic macular edema. Improvement of CRT is maintained up to the fourth month in 50% of the eyes. Repeated IDI may result in long-term clinically significant benefits.