Title of article :
Efficacy of Intravitreal Dexamethasone Implant in Different Patterns of Diabetic Macular Edema
Author/Authors :
Furino, Claudio Department of Medical Science - Neuroscience and Sense Organs - Eye Clinic - University of Bari - Bari - Italy , Niro, Alfredo Eye Clinic - Hospital “S. G. MOSCATI” - ASL TA - Taranto - Italy , Reibaldi, Michele Eye Clinic - University of Catania - Catania - Italy , Boscia, Francesco Department of Surgical - Microsurgical and Medical Sciences - Eye Clinic - University of Sassari - Sassari - Italy , Alessio, Giovanni Department of Medical Science - Neuroscience and Sense Organs - Eye Clinic - University of Bari - Bari - Italy
Abstract :
Purpose: Different patterns of diabetic macular edema (DME) suggest different pathogenesis and drug response. We evaluated the outcomes after intravitreal dexamethasone (DEX) implant for DME with or without serous retinal detachment (SRD).
Methods: In this retrospective study, 22 naïve patients (23 eyes) with DME who underwent
a single DEX implant were evaluated. Based on the optical coherence tomographic pattern
of DME, 12 eyes had a cystoid macular edema pattern (Group 1) and 11 eyes had an
SRD pattern (Group 2). The best-corrected visual acuity (BCVA), central retinal thickness
(СRТ), central retinal volume (CRV), SRD height (SRDh), and intraocular pressure (IOP) were
recorded before and at two and four months after the treatment.
Results: There were no significant differences between the groups regarding
demographic, clinical data and outcomes at baseline. In Group 1, the CRT and CRV
significantly decreased at two months (P = 0.002 and P = 0.01, respectively), while the
BCVA significantly improved at four months (P = 0.03). In Group 2, the CRT and CRV
significantly improved (P < 0.01 and P ≤ 0.01, respectively) during the follow-up period. At
four months, both groups showed a recurrence of DME, Group 1 in particular (two-month
CRT reduction, –149 ± 127 μm vs four-month CRT reduction, –72 ± 174 μm; P = 0.04). The
mean reduction in CRV was significantly different at four months (Group 1, –0.49 ± 1.7
mm3 vs Group 2, –1.3 ± 1.3 mm3; P = 0.04). In Group 2, the SRDh significantly decreased
at two (P = 0.01) and four months (P = 0.01). Four cases with elevated IOP were managed.
Conclusion: DEX implants were found to be effective in different patterns of DME. The SRD pattern may predict a longer-lasting morphologic efficacy.
Keywords :
Dexamethasone Implant , Diabetic Macular Edema , OCT , Ozurdex® , Subretinal Detachment
Journal title :
Journal of Ophthalmic and Vision Research