Abstract
Purpose:
To describe the changes in retinal thickness(RT) and visual acuity over time in patients with clinically significant refractory diffuse diabetic macular oedema (DME) after intravitreal implant of dexamethason (OZURDEX) .
Methods:
Retrospective, interventional nonrandomized case series of patients that underwent intravitreal implant of dexamethasone for chronic diabetic macular oedema refractory to previous treatment. All patients had best corrected visual acuity, slit-lamp biomicroscopy, intraocular pressure check and OCT at 1 week, 1, 3 and 6 months.
Results:
We analize 33 eyes of 32 patients, 23 male and 9 female, that underwent intravitreal implant of dexamethasone. All patients had previously had treatment with either argon laser, anti-VEGF, triamcinolone or a combination of these treatments. Retinal thickness measured by OCTdecreased in all eyes. The reduction of edema was maximal in the first month and tended to be stable for more than 3 months in some cases. We observed statistically significant decrease in central macular thickness from baseline .496.6um to 294.7um (P<0.0001) in the third month, and 356.9 (p=0.0015)um in the sixth month. Visual acuity improved in some cases, but this improvement over time was not significant.
Conclusions:
Intravitreal implant of dexamethason appears to be promising in the short term, for improving retinal thicknes more than visual acuity in eyes whith chronic macular oedema unresponsive to other treatments. Randomised controlled trials with longer follow up are required to define optimum treatment regimens.
Keywords: 498 diabetes •
503 drug toxicity/drug effects •
688 retina