An eighteen-month follow-up study on the effects of intravitreal dexamethasone implant in diabetic macular edema refractory to anti-VEGF therapy

Fernanda Pacella, Maria Rosaria Romano, Paolo Turchetti, Giovanna Tarquini, Anna Carnovale, Antonella Mollicone, Alessandra Mastromatteo, Elena Pacella

Research output: Contribution to journalArticlepeer-review

Abstract

AIM: To evaluate the long-term efficacy and safety of dexamethasone implants in subjects affected by diabetic macular edema (DME) resistant to anti -vascular endothelial growth factor (VEGF) therapy. METHODS: Thirty-two DME patients were enrolled. A 700 microgram slow release Intravitreal Dexamethasone Implant (Ozurdex®) was placed in the vitreous cavity. All patients were followed for 18mo. Best -corrected visual acuity (BCVA) measured with Early Treatment Diabetic Retinopathy Study (ETDRS) and central macular thickness (CMT) exams were carried out at baseline (T0) and after 1 (T1), 3 (T3), 4 (T4), 6 (T6), 9 (T9), 12 (T12), 15 (T15), and 18mo (T18) post injection. RESULTS: Repeated measures ANOVA showed an effect of treatment on ETDRS (<0.0001). Post hoc analyses revealed that ETDRS values were significantly increased at T1, T3, T4, T9, and T15 (<0.001) as compared to baseline value (T0). At T6, T12, and T18, ETDRS values were still statistically higher than baseline (<0.001 T0). However, at these time points, we observed a trend to return to baseline conditions. ANOVA also showed an effect of treatment (<0.0001). CMT decreased significantly at T1, T3, T4, T9, and T15 (<0.001). At T6 (<0.01), T12 and T18 (<0.001) CMT was also significantly lower than T0 although a trend to return to the baseline conditions was also observed. CONCLUSION: Our findings demonstrate that Intravitreal Dexamethasone Implant is a good option to improveBCVA and CMT in DME patients resistant to anti -VEGF therapy. Our data also show that the use of drugs administered directly into the vitreous allows achieving appropriate and long-lasting concentration at the site of disease without systemic side effects.

Original languageEnglish
Pages (from-to)1427-1432
Number of pages6
JournalInternational Journal of Ophthalmology
Volume9
Issue number10
DOIs
Publication statusPublished - Oct 18 2016

Keywords

  • Anti-vascular endothelial growth factor therapy
  • Diabetic macular edema
  • Intravitreal dexamethasone implant

ASJC Scopus subject areas

  • Ophthalmology

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