Short-term results of intravitreal dexamethasone implant [OZURDEX[registered sign]] in treatment of recalcitrant diabetic macular edema: a case series

ABSTRACT

Dexamethasone Posterior-Segment Drug Delivery System is a novel, biodegradable, sustained-release drug delivery system [OZURDEX[registered sign]] for treatment of macular edema following retinal vein occlusion and posterior uveitis. However, its potential role in management of diabetic macular edema has not been reported yet. The aim was to evaluate the safety and efficacy of [OZURDEX[registered sign]] in patients with recalcitrant diabetic macular edema [DME]. A retrospective, interventional case series from a tertiary eye care center in India is presented. Inclusion criteria comprised patients presenting with recalcitrant DME, 3 or more months after one or more treatments of macular laser photocoagulation and/or intravitreal anti-vascular endothelial growth factor [VEGF] injections. Exclusion criteria included history of corticosteroid-responsive intraocular pressure [IOP] rise, cataract extraction, or other intraocular surgery within 3 months. The main outcome measure was visual acuity at 1 and 4 months after OZURDEX[registered sign] injection. Secondary outcome measures included change in central macular thickness on Optical coherence tomography [OCT] and changes in IOP following intravitreal OZURDEX[registered sign] implant. Of 18 eyes [17 patients] with recalcitrant diabetic macular edema that underwent OZURDEX[registered sign] implant, three eyes [two patients] had follow-up of more than 3 months post-injection. Mean age of patients was 56 years. Mean duration of diabetes mellitus was 16.6 years. Systemic control of DM was good as assessed by FBS/PPBS and HbA1c. The pre-operative mean central macular thickness was 744.3 micro m and improved to 144 and 570 micro m at months 1 and 4, respectively. Preoperative mean BCVA was 0.6 logMAR units and improved to 0.3 and 0.46 logMAR units at month 1 and 4, respectively. The mean follow-up was 4.3 months [range 4-5 months]. OZURDEX[registered sign] appears efficacious in management of recalcitrant diabetic macular edema. The results of the ongoing POSURDEX[registered sign] study will elaborate these effects better