Abstract
Purpose :
Diabetic macula oedema (DMO) remains one of the most common causes of visual loss in the industrial working-age population. Intravitreal Ozurdex Implant (dexamethasone 0.7 mg) is an established treatment option for management of DMO with favorable long-term outcomes, however, one of its side effects is increase in intraocular pressure (IOP). The duration of Ozurdex action varies from 3-6 months. The purpose of this study is to investigate the differences in functional and structural outcomes as well as effect on IOP for patients receiving 1, 2 or 3 Ozurdex intravitreal implants in the first 12 months of treatment at 24-month post-treatment initiation in a real-life setting.
Methods :
Retrospective study of patients with DMO treated with Ozurdex implants between January 2016 and October 2019, at Sunderland Eye Infirmary, UK. The number of Ozurdex implants injected in the first 12 months of treatment were calculated for each patient.
The primary outcome measures were mean changes from baseline in best-corrected visual acuity (BCVA), central macular thickness (CMT) and IOP at 24 months. Secondary outcomes included proportions of patients with ≥10 letters gain or loss; ≥20% of CMT gain or loss and final BCVA and CMT.
Results :
89 eyes (74 patients) were included in the study, with 43, 35 and 11 eyes receiving 1, 2 or 3 implants, respectively, in the first 12 months. The baseline BCVA was similar in all 3 groups (55.2, 54.1, 54.8 letters, respectively, p=0.80). At 24 months, the group receiving 3 Ozurdex implants demonstrated the highest increase in BCVA of 9.88 letters compared to 1.23 and -1.20 letters for group 1 and 2, respectively, although significance was limited by small sample size (p=0.24). Reduction in CMT was -78.91μM, -102.53μM and -189.00μM for 1, 2 and 3 Ozurdex implants, respectively (p=0.08). There has been a minor IOP change from baseline of -0.76mmHg, 2.47mmHg, 2.13mmHg (p=0.973) in 1, 2 and 3 Ozurdex implant groups, yet this was clinically insignificant.
Conclusions :
The results of our real-life study showed that early treatment with multiple frequent Ozurdex implants in the first year (3 implants) yielded better functional and structural outcomes at 24 months as compared to patients’ groups treated less frequently (1 or 2 implants) though this hasn’t reached statistical significance levels with no clinical significant safety concerns.
This is a 2021 ARVO Annual Meeting abstract.