title: Dexamethasone intravitreal implants for diabetic macular edema refractory to ranibizumab monotherapy or combination therapy.
abstract: OBJECTIVE
  To determine the effectiveness and local safety of dexamethasone intravitreal implants as a treatment in diabetic macular edema (DME) refractory to intravitreal injections of ranibizumab monotherapy or combination therapy.
  
  
  METHODS
  A retrospective study conducted on patients with DME refractory to ranibizumab monotherapy or combined with other treatments treated with dexamethasone intravitreal implants. The parameters analyzed were visual acuity (VA) by ETDRS (Early Treatment Diabetic Retinopathy Study) charts and foveal thickness by spectral-domain optical coherence tomography (SD-OCT) before the treatment, 2 months after treatment, and at the end of the follow-up.
  
  
  RESULTS
  A total of 14 eyes of 14 patients were included, with a mean age of 64 years (SD: 9.5; range 41-78) and a mean follow-up of 7.6 months. The mean VA improved from 53 letters to 59 letters at 2 months (P=.03), and 57 at the end of the follow-up period (P=.3). The mean foveal thickness decreased from 502 μ to 304 μ at 2 months (P=.001), and 376 μ at the end of the follow-up period (P=.009). Further treatment with intravitreal dexamethasone was required in 43% of the patients, and 21% had increased intraocular pressure, which was controlled with topical medication.
  
  
  CONCLUSIONS
  Intravitreal dexamethasone implant is an effective and locally safe treatment for the management of DME refractory to ranibizumab monotherapy or combined with other treatments.
authors.affiliation: Departamento de Oftalmología, Hospital Universitari de Bellvitge, Barcelona, España. Electronic address: laura.gutierrez.benitez@gmail.com.
authors.forename: L
authors.initials: L
authors.lastname: Gutiérrez-Benítez
authors.affiliation: Departamento de Oftalmología, Hospital Universitari de Bellvitge, Barcelona, España.
authors.forename: E
authors.initials: E
authors.lastname: Millan
authors.affiliation: Departamento de Oftalmología, Hospital Universitari de Bellvitge, Barcelona, España.
authors.forename: L
authors.initials: L
authors.lastname: Arias
authors.affiliation: Departamento de Oftalmología, Hospital Universitari de Bellvitge, Barcelona, España.
authors.forename: P
authors.initials: P
authors.lastname: Garcia
authors.affiliation: Departamento de Oftalmología, Hospital Universitari de Bellvitge, Barcelona, España.
authors.forename: E
authors.initials: E
authors.lastname: Cobos
authors.affiliation: Departamento de Oftalmología, Hospital Universitari de Bellvitge, Barcelona, España.
authors.forename: M
authors.initials: M
authors.lastname: Caminal
mesh_terms: D000328:Adult; D000368:Aged; D002386:Cataract / Q000139:chemically induced; D003907:Dexamethasone / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use; D003930:Diabetic Retinopathy / Q000188:drug therapy*; D004343:Drug Implants; D004351:Drug Resistance; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D008269:Macular Edema / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D009798:Ocular Hypertension / Q000139:chemically induced; D000069579:Ranibizumab / Q000627:therapeutic use*; D012189:Retrospective Studies; D041623:Tomography, Optical Coherence; D014792:Visual Acuity; D014822:Vitreous Body
chemical_list: D004343:Drug Implants; D003907:Dexamethasone; D000069579:Ranibizumab
keywords: Agudeza visual; Diabetes mellitus; Edema macular; Implante de dexametasona intravítreo; Intravitreal dexamethasone implant; Macular edema; Optical coherence tomography; Ranibizumab; Tomografía de coherencia óptica; Visual acuity