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(R)) 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 microm and decreased to 325 +/- 64.21 microm (p = 0.008) and 300.22 +/- 59.46 microm (p = 0.008) at 1 month and 3 months, respectively, then increased to 468.44 +/- 150.85 microm (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.