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KMID : 0360220150560081201
Journal of the Korean Ophthalmological Society
2015 Volume.56 No. 8 p.1201 ~ p.1207
Short-Term Results of Dexamethasone Intravitreal Implant in Patients with Refractory Diabetic Macular Edema
Lee Seung-Hee

Kim Si-Yeol
Park Han-Sang
Abstract
Purpose: To evaluate the effectiveness of a dexamethasone intravitreal implant (Ozurdex) in the treatment of diabetic macular edema refractory to combined treatment of bevacizumab and triamcinolone.

Methods: We reviewed 9 eyes of 9 patients with diabetic macular edema treated with dexamethasone intravitreal implant. The patients were included in the study if presenting with refractory diabetic macular edema of more than 3 months despite combined treatment of intravitreal bevacizumab injection with posterior subtenon triamcinolone injection or intravitreal triamcinolone injection. We assessed the best-corrected visual acuity (BCVA) and central macular thickness (CMT) using optical coherence tomography at initial visit and 1, 3 and 4 months.

Results: The mean follow-up was 6.7 ¡¾ 2.2 months. The baseline mean BCVA was 0.81 ¡¾ 0.47 logarithm of the minimum angle of resolution (log MAR), which improved to 0.61 ¡¾ 0.37 log MAR (p = 0.017), 0.57 ¡¾ 0.38 log MAR (p = 0.011) and 0.62 ¡¾ 0.36 log MAR (p = 0.027) at 1 month, 3 months and 4 months, respectively. The baseline mean CMT was 558.0 ¡¾ 110.32 ¥ìm and decreased to 325 ¡¾ 64.21 ¥ìm (p = 0.008) and 300.22 ¡¾ 59.46 ¥ìm (p = 0.008) at 1 month and 3 months, respectively, then increased to 468.44 ¡¾ 150.85 ¥ìm (p = 0.058) at 4 months after injection.

Conclusions: Dexamethasone intravitreal implant showed short-term efficacy in the treatment of diabetic macular edema refractory to combined treatment of bevacizumab and triamcinolone and produced significant improvements in BCVA and CMT until 3 months after injection. The CMT then increased, but BCVA was sustained until the fourth month.
KEYWORD
Dexamethasone implant, Diabetic macular edema, Intravitreal injection
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