Short-Term Results of Dexamethasone Intravitreal Implant in Patients with Refractory Diabetic Macular Edema

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 ± 2.2 months. The baseline mean BCVA was 0.81 ± 0.47 logarithm of the minimum angle of resolution (log MAR), which improved to 0.61 ± 0.37 log MAR (p = 0.017), 0.57 ± 0.38 log MAR (p = 0.011) and 0.62 ± 0.36 log MAR (p = 0.027) at 1 month, 3 months and 4 months, respectively. The baseline mean CMT was 558.0 ± 110.32 μm and decreased to 325 ± 64.21 μm (p = 0.008) and 300.22 ± 59.46 μm (p = 0.008) at 1 month and 3 months, respectively, then increased to 468.44 ± 150.85 μm (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. J Korean Ophthalmol Soc 2015;56(8):1201-1207