Efficacy of dexamethasone intravitreal implant for the treatment of diabetic macular edema

Eur J Ophthalmol. 2015 Sep-Oct;25(5):448-53. doi: 10.5301/ejo.5000581. Epub 2015 Feb 10.

Abstract

Purpose: To assess the efficacy of a single dexamethasone intravitreal implant (Dex-I) injection for the treatment of diabetic macular edema (DME).

Methods: This was a retrospective chart review of 39 eyes (34 consecutive patients). Best-corrected visual acuity (BCVA), central macular thickness (CMT), and increase in intraocular pressure (IOP) (gt;24 mm Hg) were analyzed before treatment and 2 and 4 months after injection.

Results: Preoperative mean CMT was 559 ± 111 μm and decreased to 338 ± 84 and 477 ± 140 μm 2 and 4 months after injection, respectively. Although all eyes showed a significant decrease in CMT 2 months after injection (p<0.0001), a recurrence of the macular edema was observed 4 months after injection in 79% of eyes. Mean BCVA improvement (logMAR) was 0.13 ± 0.18 (p<0.0001) and 0.07 ± 0.21 (p = 0.049) 2 and 4 months after injection, respectively, without significant difference between vitrectomized and nonvitrectomized eyes. Eight eyes (21%) developed reversible increase in IOP 2 months after injection.

Conclusions: Thirty percent of DME eyes had gained more than 2 logMAR lines 2 months after Dex-I injection and safety was good. Visual acuity gain was maintained 4 months after injection despite a recurrence of edema in most cases.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Dexamethasone / administration & dosage*
  • Drug Implants*
  • Female
  • Glucocorticoids / administration & dosage*
  • Humans
  • Intraocular Pressure / drug effects
  • Intraocular Pressure / physiology
  • Intravitreal Injections
  • Macular Edema / drug therapy*
  • Macular Edema / physiopathology
  • Male
  • Middle Aged
  • Retrospective Studies
  • Tomography, Optical Coherence
  • Visual Acuity / drug effects
  • Visual Acuity / physiology
  • Vitreous Body / drug effects

Substances

  • Drug Implants
  • Glucocorticoids
  • Dexamethasone