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Giuseppe Lo Giudice, Antonio Avarello, Morena Masetto, Alessandro Galan; Early effect of dexamethasone intravitreal implant for diabetic macular edema in the clinical setting.. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):1770.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate the early effect of dexamethasone intravitreal implant (Ozurdex®; Allergan Inc, Irvine, CA, USA) in patients with recalcitrant diabetic macular edema (DME).
Prospective, non-randomized, interventional clinical series. Patients (n = 20 eyes) with recalcitrant DME, 4 or more months after one or more treatments of macular laser photocoagulation and/or intravitreal anti-vascular endothelial growth factor (VEGF), injections, best-corrected visual acuity (BCVA) of 20/32 to 20/200 Snellen equivalent, and central retinal thickness (CRT) of ≥300 μm by optical coherence tomography (OCT) were recruited. Exclusion criteria included history of corticosteroid-responsive intraocular pressure (IOP) rise, cataract extraction, or other intraocular surgery within 3 months; vitrectomized eyes were also excluded. Patients underwent single implant with Ozurdex® implant 0.7 mg, followed at 3 hours, 3,7, and 30 days after treatment. The main outcome was change in central macular thickness on OCT in response to Ozurdex® injection. Secondary outcome measures included visual acuity and changes in IOP following intravitreal implant.
Mean age of patients was 65 years. Mean duration of diabetes mellitus was 14.4 years. Systemic control of DM as assessed by FBS/PPBS and HbA1c. The pre-operative mean central macular thickness was 744 μm and improved to 626 μm, 470 μm, 325 and 240 μm at 3 hours, 3, 7 and 30-day respectively. Preoperative mean BCVA was 0.6 logMAR units and improved to 0.3 and 0.45 logMAR units at 7 and 30 days, respectively. All patients experienced a controlled IOP after the injection with 2 out of 20 eyes affected by transient increasing IOP during follow-up
Ozurdex® appears efficacious in management of recalcitrant diabetic macular edema with significant improvements in best-corrected visual acuity and central macular thickness from the third hour of implant in DME sufferers, and this improvement was sustained during follow-up.
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