J Korean Ophthalmol Soc > Volume 56(8); 2015 > Article
Journal of the Korean Ophthalmological Society 2015;56(8):1201-1207.
DOI: https://doi.org/10.3341/jkos.2015.56.8.1201    Published online August 15, 2015.
Short-Term Results of Dexamethasone Intravitreal Implant in Patients with Refractory Diabetic Macular Edema.
Seung Hee Lee, Si Yeol Kim, Han Sang Park
Nune Eye Hospital, Daegu, Korea. fhak02@naver.com
난치성 당뇨황반부종에서 유리체강 내 덱사메타존 임플란트의 단기 치료 효과
이승희⋅김시열⋅박한상
누네안과병원
Received: 16 January 2015   • Revised: 8 April 2015   • Accepted: 25 June 2015
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.
Key Words: Dexamethasone implant;Diabetic macular edema;Intravitreal injection


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