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Changes in visual acuity, central foveal thickness and choroidal thickness in refractory diabetic macular edema after intravitreal dexamethasone implant

Session Details

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           

Abstract Details

Purpose:

To investigate the functional and anatomical responses in patients with refractory diabetic macular edema (DME) after intravitreal injection of dexamethasone implant..

Setting:

Retrospective interventional case series. Department of Ophthalmology, Gangnam Severance Hospital, Seoul, Korea

Methods:

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).

Results:

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).

Conclusions:

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.

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