Comparison of the Effect of Intravitreal Dexamethasone Implant in Vitrectomized and Nonvitrectomized Eyes for the Treatment of Diabetic Macular Edema.

Sadık Görkem Çevik,Remzi Avcı,Fatma Düriye Akalp,Mediha Tok Çevik,Sami Yılmaz

doi:10.1155/2018/1757494

Abstract

Purpose To compare the effectiveness of sustained-release dexamethasone (DEX) intravitreal implant in nonvitrectomized eyes and vitrectomized eyes with diabetic macular edema (DME). Methods A retrospective review of the medical records of 40 eyes of 30 consecutive patients with diabetic macular edema who underwent intravitreal DEX implant injection. Patients were divided into 2 subgroups: 31 eyes that were nonvitrectomized (group 1) and 9 eyes that had previously undergone standard pars plana vitrectomy (group 2). The main outcome measures were BCVA and foveal thickness (FT). Results A significant improvement was seen in BCVA in both group 1 and group 2 at the 1st, 2nd, and 6th months after treatment with DEX implant (p < 0.05). In group 1, a significant reduction in FT was observed at the 1st, 2nd, and 6th months (p < 0.05). In group 2, a significant reduction in FT was seen at the 1st and 2nd months (p < 0.05), but the reduction rate at the 6th month after the injection was not statistically significant (p = 0.06). Conclusion DEX implant is effective for the treatment of diabetic macular edema, and the effectiveness of the drug is similar in vitrectomized and nonvitrectomized eyes.

Highlights

Diabetic macular edema is one of the most important causes of blindness worldwide affecting those individuals of working age [1,2,3]
Since the recognition of the role of inflammation and importance of the vascular endothelial growth factor (VEGF) in the pathogenesis of diabetic retinopathy, treatment options have been altered with anti-VEGF drugs, and corticosteroids have taken an active role in the treatment of diabetic retinopathy [4,5,6,7]
This research aimed to compare the effective duration of a slow-release dexamethasone implant (Ozurdex) in vitrectomized and nonvitrectomized eyes for the treatment of diabetic macular edema

Summary

Introduction

Diabetic macular edema is one of the most important causes of blindness worldwide affecting those individuals of working age [1,2,3]. Dexamethasone and triamcinolone are the most frequently used corticosteroids. Despite the many new treatments that are available, a pars plana vitrectomy (PPV) is still required in some diabetic patients. The vitreoretinal tractions can be released, and the inflammatory stimulators that cause macular edema can be removed via PPV [10]. AntiVEGF drugs, 5-FU, triamcinolone, and amphotericin B have been observed to clear out more rapidly in patients who have undergone PPV; the effective duration has been reported to be shorter than expected [11,12,13,14,15]

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