title: [Efficacy of intravitreal dexamethasone implants in macular edema excluding venous occlusions: results for a cohort of 80 patients].
abstract: BACKGROUND
  The intravitreal dexamethasone implant has shown efficacy in the treatment of macular edema (ME) arising after retinal venous occlusions (central or branch), and in the treatment of non-infectious uveitis. The purpose of this study was to evaluate the efficacy of this implant in the treatment of other diffuse macular edemas with an inflammatory mechanism.
  
  
  METHODS
  We carried out a retrospective cohort study over 2 years: from January 2012 to December 2013, including all patients who received at least one injection of intravitreal dexamethasone implant, excluding venous occlusions and non-infectious uveitis. The primary study parameter was the progression of visual acuity. The study protocol had the approval of the institutional review board of the respective clinical ethics committees, and was conducted in accordance to the tenets of the Declaration of Helsinki.
  
  
  RESULTS
  Eighty patients were included. Eighty-eight percent of patients were pseudophakic. The indications for treatment were: diabetic ME when anti-VEGF were ineffective (53%), ME after retinal detachment (RD) (22%), ME of Irvine-Gass syndrome (16%), ME after endophthalmitis (4%), macular telangiectasia (4%), ME secondary to retinitis pigmentosa (1%). The mean ETDRS visual acuity was 53.7 letters prior to injection, improving to 62.3 letters after injection (P<0.001). The average gain in visual acuity was 6.7 letters [4.53;8.84] (P<0.001) in patients treated for diabetic ME, 9.6 letters [6.1;13.1] (P<0.001) in patients with ME after RD, and 15.2 letters [10.25;20.28] (P<0.001) for Irvine-Gass syndrome. The mean duration of efficiency was 4.6 months, with a median of 3.8 months.
  
  
  CONCLUSIONS
  The intravitreal dexamethasone implant appears to be an effective second-line treatment even in patients with diabetic ME after failure or in the case of contraindication of anti-VEGF. It is also effective and well tolerated in patients with ME after RD, as well as in patients with Irvine-Gass syndrome.
authors.affiliation: Centre hospitalier national ophtalmologique des Quinze-Vingts, 28, rue de Charenton, 75012 Paris, France; Service d'ophtalmologie, centre hospitalier universitaire de Caen, avenue de la Côte-de-Nacre, 14033 Caen cedex, France. Electronic address: alice.degoumois@gmail.com.
authors.forename: A
authors.initials: A
authors.lastname: Degoumois
authors.affiliation: Centre hospitalier national ophtalmologique des Quinze-Vingts, 28, rue de Charenton, 75012 Paris, France.
authors.forename: J
authors.initials: J
authors.lastname: Akesbi
authors.affiliation: Centre hospitalier national ophtalmologique des Quinze-Vingts, 28, rue de Charenton, 75012 Paris, France.
authors.forename: C
authors.initials: C
authors.lastname: Laurens
authors.affiliation: Centre hospitalier national ophtalmologique des Quinze-Vingts, 28, rue de Charenton, 75012 Paris, France.
authors.forename: F-T
authors.initials: FT
authors.lastname: Rodallec
authors.affiliation: Centre hospitalier national ophtalmologique des Quinze-Vingts, 28, rue de Charenton, 75012 Paris, France.
authors.forename: R
authors.initials: R
authors.lastname: Adam
authors.affiliation: Centre hospitalier national ophtalmologique des Quinze-Vingts, 28, rue de Charenton, 75012 Paris, France.
authors.forename: E
authors.initials: E
authors.lastname: Blumen-Ohana
authors.affiliation: Centre hospitalier national ophtalmologique des Quinze-Vingts, 28, rue de Charenton, 75012 Paris, France.
authors.forename: O
authors.initials: O
authors.lastname: Laplace
authors.affiliation: Centre hospitalier national ophtalmologique des Quinze-Vingts, 28, rue de Charenton, 75012 Paris, France.
authors.forename: C
authors.initials: C
authors.lastname: Virevialle
authors.affiliation: Centre hospitalier national ophtalmologique des Quinze-Vingts, 28, rue de Charenton, 75012 Paris, France.
authors.forename: B
authors.initials: B
authors.lastname: Le Dû
authors.affiliation: Centre hospitalier national ophtalmologique des Quinze-Vingts, 28, rue de Charenton, 75012 Paris, France.
authors.forename: V
authors.initials: V
authors.lastname: Guyader
authors.affiliation: Centre hospitalier national ophtalmologique des Quinze-Vingts, 28, rue de Charenton, 75012 Paris, France.
authors.forename: J-P
authors.initials: JP
authors.lastname: Nordmann
mesh_terms: D000368:Aged; D015331:Cohort Studies; D003907:Dexamethasone / Q000008:administration & dosage*; D004343:Drug Implants; D005260:Female; D006801:Humans; D058449:Intravitreal Injections; D008269:Macular Edema / Q000188:drug therapy* / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D012170:Retinal Vein Occlusion; D012189:Retrospective Studies; D016896:Treatment Outcome; D014821:Vitrectomy / Q000706:statistics & numerical data; D014822:Vitreous Body
chemical_list: D004343:Drug Implants; D003907:Dexamethasone
keywords: Diabetes; Diabète; Décollement de rétine; Endophtalmie; Endophthalmitis; Implant intravitréen de dexaméthasone; Intravitreal dexamethasone implant; Irvine-Gass syndrome; Macular edema; Macular telangiectasia; Retinal detachment; Retinitis pigmentosa; Rétinopathie pigmentaire; Syndrome d’Irvine-Gass; Télangiectasies maculaires; Œdème maculaire