Abstract
Purpose :
To report the “real-life” efficacy and safety outcomes of intravitreal dexamethasone (DEX) implant as first line treatment in diabetic macular edema (DME).
Methods :
Retrospective study of 31 consecutive patients (45 eyes) with DME treated by DEX implant as first-line therapy. Main outcome measures included the evolution of best-corrected visual acuity (BCVA) and central foveal thickness (CFT) overtime, retreatment interval and tolerance profile.
Results :
Overall, 2.53 ± 1.9 DEX implants were administrated over a 3-year follow-up period and 29 eyes (64.4%) received multiple injections (≥ 2). BCVA gains as compared to baseline values were +9.5 letters (p = 0.007), +15.4 letters (p = 0.03) and +9.9 letters (p = 0.18) respectively after 12, 24 and 36 months. Mean BCVA increased by an average of +7.8 letters (p < 0.0001), +5.8 letters (p = 0.004), +7.1 letters (p = 0.007) and +1.2 letters (p = 0.79) respectively 1, 3, 6 and 12 months after the latest DEX injection. Mean CFT decreased by -196.8 mm (p < 0.0001), -168.3 mm (p < 0.0001), - 97.6 mm (p = 0.006) and –41 mm (p = 0.27) respectively 1, 3, 6 and 12 months after the latest DEX injection. Seven eyes (15.6%) showed transient increase of intraocular pressure and 68% of phakic eyes underwent cataract surgery during the follow-up.
Conclusions :
DEX implant allows long-term functional and anatomical improvement in naïve patients with DME with a good safety profile in real-life practice.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.