Intravitreal dexamethasone implant in patients with persistent diabetic macular edema.
OBJECTIVE
To evaluate the effects of a single injection of Ozurdex over 6 months in eyes with persistent diabetic macular edema (DME).


METHODS
In this retrospective interventional study, 9 patients with decreased visual acuity, as a result of persistent DME, received Ozurdex (intravitreal dexamethasone implant 0.7 mg). Main outcome measures included changes in best-corrected visual acuity (BCVA) and central retinal thickness (CRT).


RESULTS
Nine eyes of 9 patients (5 males, 4 females; mean age 58 years) were included in the analysis. The mean duration of DME was 49.9 months (range 24-85). All patients had undergone previous treatments for DME (intravitreal injection of anti-vascular endothelial growth factor, steroids or laser photocoagulation) before entering the study. At baseline, the mean BCVA was 0.74 ± 0.33 logMAR, and the mean CRT was 502 ± 222.16 µm. The mean BCVA was unchanged on the third day (0.74 ± 0.38 logMAR, p = 0.5), improved to 0.62 ± 0.32 logMAR (p = 0.02), 0.59 ± 0.26 logMAR (p = 0.02) and 0.63 ± 0.38 logMAR (p = 0.6) after the first, third and fourth months, respectively, and decreased again to 0.73 ± 0.35 logMAR (p = 0.4) at 6 months. The mean CRT improved to 397 ± 115.31 µm (p = 0.17), 271 ± 99.97 µm (p = 0.007), 325 ± 133.05 µm (p = 0.03) and 462 ± 176.48 µm (p = 0.36) on the third day and after 1, 3 and 4 months of follow-up and then increased again to 537 ± 265.42 µm (p = 0.33) at 6 months. Eight patients needed retreatments in the sixth month. One eye developed a transient intraocular pressure (IOP) increase 1 month after injection, which was successfully managed with topical IOP-lowering medication.


CONCLUSIONS
In eyes with persistent DME, Ozurdex produces improvement in BCVA and CRT as soon as the first days after the injection. Such improvement is maintained until the fourth month.
Department of Ophthalmology, University Scientific Institute San Raffaele, Via Olgettina 60, Milan, Italy.
Ilaria
I
Zucchiatti
Rosangela
R
Lattanzio
Giuseppe
G
Querques
Lea
L
Querques
Claudia
C
Del Turco
Maria Lucia
ML
Cascavilla
Francesco
F
Bandello
D000328:Adult; D000368:Aged; D020533:Angiogenesis Inhibitors / Q000008:administration & dosage; D003907:Dexamethasone / Q000008:administration & dosage*; D003930:Diabetic Retinopathy / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology; D004343:Drug Implants; D005260:Female; D005451:Fluorescein Angiography; D005938:Glucocorticoids / Q000008:administration & dosage*; D006801:Humans; D017075:Laser Coagulation; D008269:Macular Edema / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D041623:Tomography, Optical Coherence; D014792:Visual Acuity / Q000502:physiology; D014822:Vitreous Body
D020533:Angiogenesis Inhibitors; D004343:Drug Implants; D005938:Glucocorticoids; D003907:Dexamethasone