June 2020
Volume 61, Issue 7
Free
ARVO Annual Meeting Abstract  |   June 2020
The Use of Topical Steroids and NSAIDs in the treatment of Diabetic Macular Edema
Author Affiliations & Notes
  • Chi Mong Or
    Ophthalmology & Visual Sciences, LSU Ophthalmology, New Orleans, Louisiana, United States
  • J. R. Gallagher
    Ophthalmology & Visual Sciences, LSU Ophthalmology, New Orleans, Louisiana, United States
  • Zhide Fang
    Ophthalmology & Visual Sciences, LSU Ophthalmology, New Orleans, Louisiana, United States
  • Maria Reinoso
    Ophthalmology & Visual Sciences, LSU Ophthalmology, New Orleans, Louisiana, United States
  • Footnotes
    Commercial Relationships   Chi Mong Or, None; J. R. Gallagher, None; Zhide Fang, None; Maria Reinoso, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science June 2020, Vol.61, 4884. doi:
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    • Get Citation

      Chi Mong Or, J. R. Gallagher, Zhide Fang, Maria Reinoso; The Use of Topical Steroids and NSAIDs in the treatment of Diabetic Macular Edema. Invest. Ophthalmol. Vis. Sci. 2020;61(7):4884.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : Diabetic macular edema (DME) is a major cause of vision loss in diabetic eye disease. Anti-VEGF agents have revolutionized the clinical management of DME. However, limitations to their use include their availability, as well as patient resistance. Our project investigates the use of topical steroid and NSAID drops in the treatment of DME to either delay intravitreal injections or to replace the need for them.

Methods : We performed a retrospective chart review of one physician’s (MR) retina patients at LSU Health Care Network. Charts were collected using International Classification of Diseases (ICD)-10 codes for both Non-Proliferative Diabetic Retinopathy (NPDR) and Proliferative Diabetic Retinopathy (PDR) associated with macular edema (within 500 microns of the fovea) in type 1 and type 2 diabetics from January 2015-February 2019. Data was collected at baseline, 1 month, and 3-6 months after initiation of therapy. Exclusion criteria included patients who had intraocular surgery or procedure (injection or laser) in the past three months and patients on oral steroids. Patient age, gender, race, type of diabetes, Hemoglobin A1C, lens status, degree of retinopathy, uncorrected visual acuity (UCVA), central macular thickness on OCT, and treatment regimen were documented at the baseline visit. UCVA change, CMT change, and degree of retinopathy were documented at each subsequent visit. Treatment failure was defined as worsening of CMT>20 microns or involvement of alternate therapy options.

Results : A total of 39 eyes met criteria. Eighty-seven percent (n= 34) had follow up at 1 month, 77% (n=30) had follow up at 3-6 months. The CMT at the baseline visit compared to the 4-week follow up visit (34 eyes) showed an improvement in 35%, and worsening in 32% of patients, with 26% of patients failing treatment. At the 3-6 month visit, 40% (30 eyes) improved, 23% worsened, and 7% failed treatment when compared to baseline. At the 3-6 month follow up, CMT had no relationship with race, change in UCVA, lens status and degree of retinopathy.

Conclusions : Our project demonstrates a viable alternative to intravitreal injections for those patients who are either unable to or choose not to commit to intravitreal injections in the treatment of DME.

This is a 2020 ARVO Annual Meeting abstract.

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