[Efficacy of intravitreal dexamethasone implant as a starting monotherapy and when switching from an anti-VEGF drug in diabetic macular edema]. / Effektivnost' intravitreal'nogo implantata s deksametazonom v kachestve startovoi monoterapii i pri pereklyuchenii s anti-VEGF-preparata pri diabeticheskom makulyarnom oteke.

PURPOSE: To conduct a comparative assessment of the effectiveness of an intravitreal dexamethasone implant as a starting monotherapy and when switching from anti-VEGF therapy for macular edema in patients with diabetes mellitus. MATERIAL AND METHODS: The study involved 112 patients (112 eyes) with diabetic macular edema. The 1st group of the study included 58 patients (58 eyes) with newly diagnosed diabetic macular edema, who had not previously received special ophthalmic treatment. Group 2 included 54 patients (54 eyes) resistant to anti-VEGF therapy after 5 intravitreal injections of aflibercept. All patients underwent monthly spectral optical coherence tomography of the macular region, as well as visometry and tonometry during the follow-up period (6 months). RESULTS: The maximum therapeutic effect in both groups was observed 3 months after intravitreal introduction of the dexamethasone implant - in 94.8% and 92.5% of cases, respectively, it contributed to an improvement in the architectonics of the retinal layers, a decrease in retinal edema and an increase in visual acuity. At the same time, the most pronounced increase in BCVA (on average up to 0.66±0.1) was observed in patients of the 1st group. CONCLUSION: This study confirmed that an intravitreal dexamethasone implant can be recommended for newly diagnosed diabetic macular edema, as just one injection leads to resolution of macular edema and high functional outcomes, which persisted in 89.6% of study patients throughout the observation period.

[Effect of internal limiting membrane peeling on morpho-functional state of the retina in patients with proliferative diabetic retinopathy (preliminary report)]. / Vliianie pilinga vnutrennei pogranichnoi membrany na morfofunktsional'nye pokazateli setchatki pri proliferativnoi diabeticheskoi retinopatii (predvaritel'noe soobshchenie).

PURPOSE: To compare morpho-functional parameters of retina during vitrectomy with and without internal limiting membrane (ILM) peeling in patients with proliferative diabetic retinopathy. MATERIAL AND METHODS: The study included 55 patients (55 eyes) that had underwent vitreoretinal surgery in the setting of antivasoproliferative therapy for proliferative diabetic retinopathy. Patients of the 1st group (n=27) underwent vitrectomy with silicone tamponade, 2nd group (n=28) received similar treatment with the addition of ILM peeling. Three months after the treatment, all patients had silicone oil removed. RESULTS: Best Corrected Visual Acuity before treatment was 0.06±0.02 in both groups; after the treatment it improved to 0.1±0.05 (p<0.05) in the 1st group and to 0.25±0.05 (p1-2<0.05) in the 2nd group. Thickness of the 'nerve fiber layer - internal limiting membrane' in the macular area was 28.67±2.21 µm in both groups before the treatment. By 3-month follow-up its thickness increased to 46.44±2.56 µm (p<0.05) in the 1st group due to the formation of epiretinal membrane (ERM). In patients of the 2nd group 'nerve fiber layer' area thickness amounted to 28.41±1.88 µm (p1-2<0.05) and ERM could not be identified in any of them. CONCLUSION: ILM peeling during vitrectomy with following silicone oil tamponade eliminates the risk of ERM formation in patients with proliferative diabetic retinopathy in the follow-up period of up to 6-month and results in better morpho-functional parameters in comparison with patients who received similar treatment but without peeling.