title: Dexamethasone Intravitreal Implant for Diabetic Macular Edema During Pregnancy.
abstract: OBJECTIVE
  To describe the management of diabetic macular edema during pregnancy with the use of a dexamethasone slow-release intravitreal implant.
  
  
  METHODS
  Retrospective, observational, consecutive case series.
  
  
  METHODS
  The study included 5 pregnant women who presented with diabetic macular edema during pregnancy in the period from 2011 to 2014. Review of charts and photographs comprised best-corrected visual acuity (BCVA), foveal center field thickness assessed by optical coherence tomography, blood pressure, glycated hemoglobin, medications, and changes in such parameters after implant injection.
  
  
  RESULTS
  Diabetic macular edema involving the foveal center was observed between gestational weeks 9 and 23 in 10 eyes of 5 patients. Dexamethasone intravitreal implant injection was given 10 times in 9 eyes with a mean preinjection center field retinal thickness of 535 μm (range, 239-727 μm) and a mean preinjection best-corrected visual acuity (BCVA) of 63 approximated Early Treatment Diabetic Retinopathy Study (approxETDRS) letters (range, 50-77 letters). One eye was unavailable for follow-up. In 7 of 8 eyes injection was followed, within 3 weeks, by a greater than 145 μm reduction in foveal center field thickness and in 6 of 8 eyes by an increase in BCVA of 5 or more approxETDRS letters. A mild transient rise in intraocular pressure occurred in 3 out of 8 eyes.
  
  
  CONCLUSIONS
  Diabetic macular edema involving the foveal center that presented during pregnancy responded promptly to intravitreal dexamethasone therapy by foveal thickness reduction and visual acuity improvement without clinically significant intraocular pressure increases.
authors.affiliation: Department of Ophthalmology, Rigshospitalet, Copenhagen, Denmark.
authors.forename: Michael
authors.initials: M
authors.lastname: Concillado
authors.affiliation: Department of Ophthalmology, Rigshospitalet, Copenhagen, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; Steno Diabetes Center, Gentofte, Denmark.
authors.forename: Henrik
authors.initials: H
authors.lastname: Lund-Andersen
authors.affiliation: Center for Pregnant Women with Diabetes, Department of Endocrinology, Rigshospitalet, Copenhagen, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
authors.forename: Elisabeth R
authors.initials: ER
authors.lastname: Mathiesen
authors.affiliation: Department of Ophthalmology, Rigshospitalet, Copenhagen, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark. Electronic address: miclar01@regionh.dk.
authors.forename: Michael
authors.initials: M
authors.lastname: Larsen
mesh_terms: D000328:Adult; D001794:Blood Pressure / Q000502:physiology; D003907:Dexamethasone / Q000008:administration & dosage*; D003930:Diabetic Retinopathy / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology; D004343:Drug Implants; D005260:Female; D005584:Fovea Centralis / Q000000981:diagnostic imaging / Q000473:pathology; D005865:Gestational Age; D005938:Glucocorticoids / Q000008:administration & dosage*; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D058449:Intravitreal Injections; D008269:Macular Edema / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology; D011247:Pregnancy; D011254:Pregnancy in Diabetics / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology; D012189:Retrospective Studies; D041623:Tomography, Optical Coherence; D014792:Visual Acuity / Q000502:physiology; D055815:Young Adult
chemical_list: D003907:Dexamethasone; D004343:Drug Implants; D005938:Glucocorticoids; D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human