title: Efficacy of single-dose dexamethasone implantation in patients with persistent diabetic macular edema.
abstract: To investigate the efficacy of single-dose intravitreal dexamethasone implantation in the treatment of persistent diabetic macular edema (DME) unresponsive to 3 consecutive ranibizumab injections over a period of 6 months. Forty-one patients with a previous history of treatment for DME including at least three consecutive intravitreal ranibizumab injections were enrolled in this retrospective study. Main outcome measures were change in best-corrected visual acuity (BCVA), central macular thickness (CMT), and intraocular pressure from baseline to 6th month. At the baseline, the mean CMT was 572.4 ± 123.1 μm which improved to 264.2 ± 114.4, 317.7 ± 141.7, 410.6 ± 169.1, and 382.8 ± 181.5 μm at the 1st, 3rd, 5th, and 6th month, respectively (p < 0.05). The preoperative mean BCVA was 0.85 ± 0.54 logMAR units which improved to 0.76 ± 0.5 (p = 0.08), 0.69 ± 0.4 (p = 0.02), 0.74 ± 0.4 (p = 0.284), and 0.72 ± 0.3 (p = 0.489) logMAR units at the 1st, 3rd, 5th, and 6th months, respectively. Additional injections were required for 13 (31 %) eyes at 3rd month and 14 (34 %) eyes at 5th month due to recurrence of macular edema. Intravitreal dexamethasone implantation caused a significant improvement of BCVA and reduction of CMT in the patients with persistent DME that were unresponsive to 3 consecutive ranibizumab injections. However, retreatment before 6 months in the majority of the patients was needed despite the beneficial effects after the index procedure.
authors.affiliation: Department of Ophthalmology, Ankara Atatürk Education and Research Hospital, Yıldırım Beyazıt University, Ankara, Turkey. mcllarkn@yahoo.com.
authors.forename: Mücella
authors.initials: M
authors.lastname: Arıkan Yorgun
authors.affiliation: Department of Ophthalmology, Ankara Atatürk Education and Research Hospital, Yıldırım Beyazıt University, Ankara, Turkey.
authors.forename: Yasin
authors.initials: Y
authors.lastname: Toklu
authors.affiliation: Department of Ophthalmology, Ankara Atatürk Education and Research Hospital, Yıldırım Beyazıt University, Ankara, Turkey.
authors.forename: Melek
authors.initials: M
authors.lastname: Mutlu
authors.affiliation: Department of Ophthalmology, Ankara Atatürk Education and Research Hospital, Yıldırım Beyazıt University, Ankara, Turkey.
authors.forename: Betül Seher
authors.initials: BS
authors.lastname: Uysal
authors.affiliation: Department of Ophthalmology, Faculty of Medicine, Hacettepe University, Ankara, Turkey.
authors.forename: Hasan Basri
authors.initials: HB
authors.lastname: Çakmak
mesh_terms: D000368:Aged; D003907:Dexamethasone / Q000008:administration & dosage*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications; D003930:Diabetic Retinopathy / Q000175:diagnosis / Q000188:drug therapy*; D004343:Drug Implants; D005260:Female; D005451:Fluorescein Angiography; D005938:Glucocorticoids / Q000008:administration & dosage*; D006801:Humans; D007429:Intraocular Pressure / Q000187:drug effects; D058449:Intravitreal Injections; D008269:Macular Edema / Q000175:diagnosis / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D041623:Tomography, Optical Coherence; D016896:Treatment Outcome; D014792:Visual Acuity / Q000187:drug effects
chemical_list: D004343:Drug Implants; D005938:Glucocorticoids; D003907:Dexamethasone
keywords: Corticosteroid; Dexamethasone; Diabetic macular edema; Optical coherence tomography