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Efficacy of dexamethasone intravitreal implant for the treatment of persistent diffuse diabetic macular edema

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Abstract

To investigate the efficiency and safety of a single injection of intravitreal dexamethasone implant in eyes with persistent diffuse diabetic macular edema (DME). In this retrospective study, 25 eyes of 20 patients, who underwent a single injection of intravitreal dexamethasone implant for the treatment of persistent diffuse DME, were reviewed. Main outcome measures included the changes in best-corrected visual acuity (BCVA) and central macular thickness (CMT) from baseline at scheduled visits following injection. The mean BCVA showed improvement from baseline (0.97 ± 0.26 logMAR) at every visit; the difference was significant at day 7 (0.85 ± 0.3 logMAR, p = 0.003), month 1 (0.77 ± 0.32 logMAR, p < 0.001), month 3 (0.77 ± 0.34 logMAR, p = 0.001), and month 4 (0.85 ± 0.31 logMAR, p = 0.014). The mean CMT was significantly lower than baseline (616 ± 132 μm) at day 1 (518 ± 144 μm), day 7 (414 ± 134 μm), month 1 (306 ± 95 μm), month 3 (339 ± 88 μm), month 4 (420 ± 116 μm), and month 6 (494 ± 128 μm) following the injection (p < 0.001, for all). Thirteen eyes on the 4-month follow-up and ten eyes on the 6-month follow-up experienced recurrence of macular edema requiring retreatment. No serious ocular and systemic adverse events were observed. In patients with persistent DME, switching to intravitreal dexamethasone implant injection provides functional and anatomical improvement, and might be an effective therapeutic option for long-standing diffuse DME.

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References

  1. Bhagat N, Grigorian RA, Tutela A, Zarbin MA (2009) Diabetic macular edema: pathogenesis and treatment. Surv Ophthalmol 54:1–32

    Article  PubMed  Google Scholar 

  2. Funatsu H, Noma H, Mimura T, Eguchi S, Hori S (2009) Association of vitreous inflammatory factors with diabetic macular edema. Ophthalmology 116:73–79

    Article  PubMed  Google Scholar 

  3. Pacella E, Vestri AR, Muscella R, Carbotti MR, Castellucci M, Coi L et al (2013) Preliminary results of an intravitreal dexamethasone implant (Ozurdex®) in patients with persistent diabetic macular edema. Clin Ophthalmol 7:1423–1428

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  4. Ho AC, Scott IU, Kim SJ, Brown GC, Brown MM, Ip MS, Recchia FM (2012) Anti-vascular endothelial growth factor pharmacotherapy for diabetic macular edema: a report by the American Academy of Ophthalmology. Ophthalmology 119:2179–2188

    Article  PubMed  Google Scholar 

  5. Grover D, Li TJ, Chong CC (2008) Intravitreal steroids for macular edema in diabetes. Cochrane Database Syst Rev 1:CD005656

    Google Scholar 

  6. Bandello F, Preziosa C, Querques G, Lattanzio R (2014) Update of intravitreal steroids for the treatment of diabetic macular edema. Ophthalmic Res 52:89–96

    Article  CAS  PubMed  Google Scholar 

  7. Jonas JB, Spandau UH, Kamppeter BA, Vossmerbaeumer U, Harder B (2006) Follow-up after intravitreal triamcinolone acetonide for diabetic macular edema. Eur J Ophthalmol 16:566–672

    CAS  PubMed  Google Scholar 

  8. Gillies MC, Sutter FK, Simpson JM et al (2006) Intravitreal triamcinolone for refractory diabetic macular edema two-year results of a double-masked, placebo-controlled, randomized clinical trial. Ophthalmology 113:1533–1538

    Article  PubMed  Google Scholar 

  9. Herrero-Vanrell Cardillo JA, Kuppermann BD (2011) Clinical applications of the sustained-release dexamethasone implant for treatment of macular edema. Clin Ophthalmol 5:139–146

    PubMed  PubMed Central  Google Scholar 

  10. Boyer DS, Yoon YH, Belfort R Jr et al (2014) Three-year, randomized, sham-controlled trial of dexamethasone intravitreal implant in patients with diabetic macular edema. Ophthalmology 121:1904–1914

    Article  PubMed  Google Scholar 

  11. Virgili G, Parravano M, Menchini F, Evans JR (2014) Anti-vascular endothelial growth factor for diabetic macular oedema. Cochrane Database Syst Rev 10:CD007419

    Google Scholar 

  12. Totan Y, Güler E, Gürağaç FB (2015) Dexamethasone intravitreal implant for chronic diabetic macular edema resistant to intravitreal bevacizumab treatment. Curr Eye Res 22:1–7

    Article  Google Scholar 

  13. Lazic R, Lukic M, Boras I et al (2014) Treatment of anti-vascular endothelial growth factor-resistant diabetic macular edema with dexamethasone intravitreal implant. Retina 34:719–724

    Article  CAS  PubMed  Google Scholar 

  14. Dutra Medeiros M, Postorino M, Navarro R, Garcia-Arumí J, Mateo C, Corcóstegui B (2014) Dexamethasone intravitreal implant for treatment of patients with persistent diabetic macular edema. Ophthalmologica 231:141–146

    Article  CAS  PubMed  Google Scholar 

  15. Rishi P, Rishi E, Kuniyal L, Mathur G (2012) Short-term results of intravitreal dexamethasone implant (OZURDEX(®)) in treatment of recalcitrant diabetic macular edema: a case series. Oman J Ophthalmol 5:79–82

    Article  PubMed  PubMed Central  Google Scholar 

  16. Zucchiatti I, Lattanzio R, Querques G et al (2012) Intravitreal dexamethasone implant in patients with persistent diabetic macular edema. Ophthalmologica 228:117–122

    Article  CAS  PubMed  Google Scholar 

  17. Zalewski D, Raczyńska D, Raczyńska K (2014) Five-month observation of persistent diabetic macular edema after intravitreal injection of Ozurdex implant. Mediators Inflamm 2014:364143

    Article  PubMed  PubMed Central  Google Scholar 

  18. Scaramuzzi M, Querques G, Spina C, Lattanzio R, Bandello F (2015) Repeated intravitreal dexamethasone implant (Ozurdex) for diabetic macular edema. Retina 35:1216–1222

    Article  CAS  PubMed  Google Scholar 

  19. Escobar-Barranco JJ, Pina-Marín B, Fernández-Bonet M (2015) Dexamethasone implants in patients with naïve or refractory diffuse diabetic macular edema. Ophthalmologica 233:176–185

    Article  CAS  PubMed  Google Scholar 

  20. Tamura H, Miyamoto K, Kiryu J et al (2005) Intravitreal injection of corticosteroid attenuates leukostasis and vascular leakage in experimental diabetic retina. Invest Ophthalmol Vis Sci 46:1440–1444

    Article  PubMed  Google Scholar 

  21. Nauck M, Roth M, Tamm M et al (1997) Induction of vascular endothelial growth factor by platelet-activating factor and platelet-derived growth factor is downregulated by corticosteroids. Am J Respir Cell Mol Biol 16:398–406

    Article  CAS  PubMed  Google Scholar 

  22. Diabetic Retinopathy Clinical Research Network, Browning DJ, Glassman AR et al (2007) Relationship between optical coherence tomography-measured central retinal thickness and visual acuity in diabetic macular edema. Ophthalmology 114:525–536

    Article  Google Scholar 

  23. Haller JA, Bandello F, Belfort R Jr et al (2010) Randomized, sham-controlled trial of dexamethasone intravitreal implant in patients with macular edema due to retinal vein occlusion. Ophthalmology 117:1134–1146

    Article  PubMed  Google Scholar 

  24. Bonnin S, Dupas B, Sanharawi ME et al (2015) Efficacy of dexamethasone intravitreal implant for the treatment of diabetic macular edema. Eur J Ophthalmol. doi:10.5301/ejo.5000581

    PubMed  Google Scholar 

  25. Panozzo G, Gusson E, Panozzo G, Mura GD (2015) Dexamethasone intravitreal implant for diabetic macular edema: indications for a PRN regimen of treatment. Eur J Ophthalmol 25:347–351

    Article  PubMed  Google Scholar 

  26. Arıkan Yorgun M, Toklu Y (2015) Comment on the article by Dutra Medeiros et al. entitled ‘dexamethasone intravitreal implant for treatment of patients with persistent diabetic macular edema’. Ophthalmologica 233:117–118

    Article  PubMed  Google Scholar 

  27. Pacella E, La Torre G, Impallara D et al (2013) Efficacy and safety of the intravitreal treatment of diabetic macular edema with pegaptanib: a 12-month follow-up. Clin Ter 164:e121–e126

    CAS  PubMed  Google Scholar 

  28. Kook D, Wolf A, Kreutzer T et al (2008) Long-term effect of intravitreal bevacizumab (avastin) in patients with chronic diffuse diabetic macular edema. Retina 28:1053–1060

    Article  PubMed  Google Scholar 

  29. Pacella E, La Torre G, Turchetti P et al (2014) Evaluation of efficacy dexamethasone intravitreal implant compared to treatment with anti-VEGF in the treatment of diabetic macular edema. Senses Sci 1:164–168

    Google Scholar 

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Authors and Affiliations

  1. Department of Ophthalmology, School of Medicine, Cukurova University, 01330, Adana, Turkey

    Ebru Esen, Selcuk Sizmaz & Nihal Demircan

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  1. Ebru Esen
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  2. Selcuk Sizmaz
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  3. Nihal Demircan
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Correspondence to Ebru Esen.

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Esen, E., Sizmaz, S. & Demircan, N. Efficacy of dexamethasone intravitreal implant for the treatment of persistent diffuse diabetic macular edema. Int Ophthalmol 37, 1–6 (2017). https://doi.org/10.1007/s10792-016-0219-2

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  • DOI: https://doi.org/10.1007/s10792-016-0219-2

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