Session Title: Vascular Diseases and Diabetic Retinopathy III
Session Date/Time: Friday 12/09/2014 | 16:30-18:00
Paper Time: 17:34
Venue: Boulevard D
First Author: : Y.J.Cho SOUTH KOREA
Co Author(s): : M. Kim H.J. Koh
To investigate the functional and anatomical responses in patients with refractory diabetic macular edema (DME) after intravitreal injection of dexamethasone implant..
Retrospective interventional case series. Department of Ophthalmology, Gangnam Severance Hospital, Seoul, Korea
Twenty six eyes of 16 patients with DME who were treated with a single intravitreal injection of 700µg dexamethasone implant(Ozurdex®) due to refractory DME were enrolled. Patients were followed up at postoperative 1, 3 and 6 months for the evaluation of changes in central foveal thickness(CFT) and subfoveal choroidal thickness(CT) by spectral-domain optical coherence tomography and best corrected visual acuity (BCVA).
The mean age of patients was 59.4± 12.35 years and all the eyes had been previously treated with intravitreal anti-VEGF injections and showed persistent DME (mean injections : 4.08 ± 2.98) The preoperative initial logMAR BCVA was 0.49 ± 0.24, which improved to 0.44 ± 0.24 at 1 month, 0.40 ± 0.24 at 3 month and 0.46 ± 0.32 at 6 months, but the changes in BCVA was not statistically significant.(All p>0.05). At baseline, the mean CFT was 526.29 ± 123.48 μm, which significantly improved to 335.48 ± 104.32 μm at 1 month, and 316.15 ± 100.09 μm at 3 month.(All p<0.001). However, CFT deteriorated to 457.07 ± 136.53 μm at 6 months and the changes of CFT became marginally significant at 6 months compared to preoperative CFT(p=0.051). Similarly, the mean preoperative subfoveal CT was 288.91 ± 36.47 μm and it decreased to 260.19 ± 33.20 μm at 1 month and 266.85 ± 30.93 μm at 3 months(all p<0.01), but increased to 278.63 ± 32.55 μm at 6 months.(p=0.137). The reduction of CFT from baseline showed significant correlation with that of subfoveal CT at 3 months(p=0.041) and at 6 months(p=0.008), whereas the correlation was marginally significant at 1 month (p=0.053).
In refractory DME, a single intravitreal injection of dexamethasone implant significantly reduced CFT and subfoveal CT during 6 month follow up, but there was no significant change in BCVA. The reduction of CFT showed significant correlation with reduction of subfoveal CT.