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Pietro Frascio, Francesca Allavena, Massimo Nicolò, Serena Telani, Carlo Traverso; Intravitreal Dexamethasone Implant in Patients with Refractory Diabetic Macular Edema. Invest. Ophthalmol. Vis. Sci. 2013;54(15):2386.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate the effects of dexamethasone intravitreal implant in eyes with refractory diabetic macular edema (DME).
In this retrospective interventional study, 4 patients with decreased visual acuity, as a result of DME refractory to treatments with anti-VEGF and/or laser photocoagulation, received a dexamethasone intravitreal implant 0.7 mg. Main outcome measures included changes in best-corrected visual acuity (BCVA) and central retinal thickness (CRT).
Six eyes of 4 patients (3 males, 1 female; mean age 70.7 years) were included in the analysis. The mean duration of DME was 36 months (range 24-48). All patients had undergone previous treatments for DME with intravitreal injections of anti-vascular endothelial growth factor, and/or laser photocoagulation before entering this study. At baseline, the mean BCVA was 0.73 logMAR, and the mean CRT was 475.2. The mean BCVA improved to 0.43 logMAR (p = 0.04), 0.41 logMAR (p = 0.04), 0.41 logMAR (p = 0.04), 0.53 logMAR (p = 0.1), 0.41 logMAR (p = 0.04) and 0.53 logMAR (p = 0.1) at 1, 2, 3, 6, 9 and 12 months of follow-up respectively. The mean CRT improved to 361.5 (p=0.003), 322.7 (p =0.004), 326.0 (p = 0.02), 349.5 (p = 0.01), 312.8 (p=0.002)and 314.3 (p=0.02) after 1, 2, 3, 6, 9 and 12 months of follow-up respectively. Two eyes were retreated at month 6 and 1 eye at month 9. One eye developed a transient intraocular pressure (IOP) increase 1 month after injection, which was successfully managed with topical IOP-lowering medication.
Our data show that in eyes with refractory DME, a dexamethasone intravitreal implant produced a statistically significant improvement in BCVA and CRT and may represent a novel therapeutic option.
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