title: Short-term results of intravitreal dexamethasone implant (OZURDEX(®)) in treatment of recalcitrant diabetic macular edema: A case series.
abstract: BACKGROUND
  Dexamethasone Posterior-Segment Drug Delivery System is a novel, biodegradable, sustained-release drug delivery system (OZURDEX(®)) for treatment of macular edema following retinal vein occlusion and posterior uveitis. However, its potential role in management of diabetic macular edema has not been reported yet.
  
  
  OBJECTIVE
  The aim was to evaluate the safety and efficacy of (OZURDEX(®)) in patients with recalcitrant diabetic macular edema (DME).
  
  
  METHODS
  A retrospective, interventional case series from a tertiary eye care center in India is presented. Inclusion criteria comprised patients presenting with recalcitrant DME, 3 or more months after one or more treatments of macular laser photocoagulation and/or intravitreal anti-vascular endothelial growth factor (VEGF) injections. Exclusion criteria included history of corticosteroid-responsive intraocular pressure (IOP) rise, cataract extraction, or other intraocular surgery within 3 months. The main outcome measure was visual acuity at 1 and 4 months after OZURDEX(®) injection. Secondary outcome measures included change in central macular thickness on Optical coherence tomography (OCT) and changes in IOP following intravitreal OZURDEX(®) implant. Of 18 eyes (17 patients) with recalcitrant diabetic macular edema that underwent OZURDEX(®) implant, three eyes (two patients) had follow-up of more than 3 months post-injection.
  
  
  RESULTS
  Mean age of patients was 56 years. Mean duration of diabetes mellitus was 16.6 years. Systemic control of DM was good as assessed by FBS/PPBS and HbA1c. The pre-operative mean central macular thickness was 744.3 μm and improved to 144 and 570 μm at months 1 and 4, respectively. Preoperative mean BCVA was 0.6 logMAR units and improved to 0.3 and 0.46 logMAR units at month 1 and 4, respectively. The mean follow-up was 4.3 months (range 4-5 months).
  
  
  CONCLUSIONS
  OZURDEX(®) appears efficacious in management of recalcitrant diabetic macular edema. The results of the ongoing POSURDEX(®) study will elaborate these effects better.
authors.affiliation: Shri Bhagwan Mahavir Vitreoretinal Services, Sankara Nethralaya, Chennai, Tamil Nadu, India.
authors.forename: Pukhraj
authors.initials: P
authors.lastname: Rishi
authors.forename: Ekta
authors.initials: E
authors.lastname: Rishi
authors.forename: Lakshmi
authors.initials: L
authors.lastname: Kuniyal
authors.forename: Gaurav
authors.initials: G
authors.lastname: Mathur