Anti-VEGF versus dexamethasone implant (Ozurdex) for the management of Centre involved Diabetic Macular Edema (CiDME): a randomized study

Sharma, Ashish; Bellala, Keerthi; Dongre, Pankaj; Reddy, Prahalad

doi:10.1007/s10792-019-01151-3

Cited by 12 publications

(11 citation statements)

References 19 publications

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“…Anti-VEGF 40 Total 58.9 Total 39/12 N/A N/A total 455.5 2.Ozurdex 19 0.41 471.6 Sever et al 25 Retrospective 2017 12 Not persisted DME 1. Ranibizumab 44 Total 56.2 N/A 5/39 N/A 0.75 372.6 2.Ozurdex 40 10/30 0.75 376.6 Shah et al 40 RCT 2016 7 Not persisted DME 1.Bevacizumab 23 61 13/10 9/14 N/A 0.52 485 2.Ozurdex 27 65 12/15 14/13 0.52 458 Sharma et al 50 RCT 2019 6 Persisted DME 1.Anti-VEGF 20 56.42 N/A 0/45 …”

Section: Resultsmentioning

confidence: 99%

Efficacy and safety profile of intravitreal dexamethasone implant versus antivascular endothelial growth factor treatment in diabetic macular edema: a systematic review and meta-analysis

Chi

Kang

Huang

2023

Sci Rep

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To better understand the efficacy of intravitreal dexamethasone implant (Ozurdex) versus antivascular endothelial growth factor (anti-VEGF) treatment in patients with diabetic macular edema (DME). A systematic review and meta-analysis. The study included randomized control trials (RCTs) and non-randomized control trials (Non-RCTs) before December 2021 that compare the efficacy of Ozurdex-related therapyand anti-VEGF therapy. We searched PubMed, Cochrane Library, and EMBASE. The quality of the included studies was assessed carefully. 30 studies were included. Regarding BCVA change, the overall result revealed no significant differences between Ozurdex and anti-VEGF therapies in patients with nonresistant DME, but Ozurdex group had significantly more VA improvement than anti-VEGF therapies in patients with resistant DME (MD 0.12, 95% CI 0.02–0.21). In terms of central retinal thickness (CRT) decrease, there was a significant difference between Ozurdex therapy and anti-VEGF therapy in patients with nonresistant DME (MD 48.10, 95% CI 19.06–77.13) and resistant DME (MD 65.37, 95% CI 3.62–127.13). Overall, Ozurdex therapy resulted in significantly greater VA improvement and CRT decrease than anti-VEGF therapy in resistant DME patients. Ozurdex therapy was not inferior to anti-VEGF therapy in patients with nonresistant DME.

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Section: Resultsmentioning

confidence: 99%

Efficacy and safety profile of intravitreal dexamethasone implant versus antivascular endothelial growth factor treatment in diabetic macular edema: a systematic review and meta-analysis

Chi

Kang

Huang

2023

Sci Rep

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“…It is further well accepted that intravitreal corticosteroid implants are effective in improving VA and reducing macular oedema in patients with DMO [129][130][131][132][133][134][135][136][137][138][139][140][141][142][143][144][145][146][147][148]. To date, there are three potent synthetic corticosteroids used in the treatment of DMO: dexamethasone, fluocinolone acetonide, and triamcinolone acetonide.…”

Section: Corticosteroidsmentioning

confidence: 99%

Diabetic Macular Oedema Guidelines: An Australian Perspective

Yuen

Gilhotra

Dalton³

et al. 2023

Journal of Ophthalmology

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The number of people living with diabetes is expected to rise to 578 million by 2030 and to 700 million by 2045, exacting a severe socioeconomic burden on healthcare systems around the globe. This is also reflected in the increasing numbers of people with ocular complications of diabetes (namely, diabetic macular oedema (DMO) and diabetic retinopathy (DR)). In one study examining the global prevalence of DR, 35% of people with diabetes had some form of DR, 7% had PDR, 7% had DMO, and 10% were affected by these vision-threatening stages. In many regions of the world (Australia included), DR is one of the top three leading causes of vision loss amongst working age adults (20–74 years). In the management of DMO, the landmark ETDRS study demonstrated that moderate visual loss, defined as doubling of the visual angle, can be reduced by 50% or more by focal/grid laser photocoagulation. However, over the last 20 years, antivascular endothelial growth factor (VEGF) and corticosteroid therapies have emerged as alternative options for the management of DMO and provided patients with choices that have higher chances of improving vision than laser alone. In Australia, since the 2008 NHMRC guidelines, there have been significant developments in both the treatment options and treatment schedules for DMO. This working group was therefore assembled to review and address the current management options available in Australia.

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“…erefore, studies have investigated combination therapy using intravitreal anti-VEGF agents with intravitreal triamcinolone acetonide [9], Rho kinase inhibitors [10], methotrexate [11], subthreshold micropulse lasers [12,13], macular grid laser photocoagulation [14], and subtenon steroid injections [15], as well as switching from anti-VEGF treatment to intravitreal dexamethasone implantation [6,[16][17][18], for DME patients.…”

Section: Introductionmentioning

confidence: 99%

“…Although anti-VEGF therapy is a cost-effective way to improve vision loss in DME [ 8 ], frequent intravitreal injections impose a high economic burden on patients, particularly in developing countries. Therefore, studies have investigated combination therapy using intravitreal anti-VEGF agents with intravitreal triamcinolone acetonide [ 9 ], Rho kinase inhibitors [ 10 ], methotrexate [ 11 ], subthreshold micropulse lasers [ 12 , 13 ], macular grid laser photocoagulation [ 14 ], and subtenon steroid injections [ 15 ], as well as switching from anti-VEGF treatment to intravitreal dexamethasone implantation [ 6 , 16 – 18 ], for DME patients.…”

Section: Introductionmentioning

confidence: 99%

Intravitreal Ranibizumab Alone or in Combination with Calcium Dobesilate for the Treatment of Diabetic Macular Edema in Nonproliferative Diabetic Retinopathy Patients: 12-Month Outcomes of a Retrospective Study

Wang

et al. 2022

International Journal of Clinical Practice

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Objective. This study investigates the efficacy of CaD combined with intravitreal ranibizumab for the treatment of diabetic macular edema (DME) in patients with nonproliferative DR. Methods. This retrospective, observational, case-control study enrolled consecutive patients newly diagnosed with DME. The patients were treated with 3-monthly loading dose injections of intravitreal ranibizumab (IVR) followed by pro re nata injections (3 + PRN), with or without daily oral CaD. The patients were treated and followed up for 12 months. We reviewed their medical records to determine the optical coherence tomography (OCT) findings, number of injections, best-corrected visual acuity (BCVA), and central macular thickness (CMT) at 3, 6, and 12 months after the first injection. Results. We reviewed 102 eyes of 102 patients; 54 patients received IVR combined with oral CaD (IVR + CaD group) and 48 received only IVR (IVR group). In both groups, BCVA was higher, and CMT was lower, at 3, 6, and 12 months after the injection compared to those at the baseline ( p < 0.05 for all), while there were no significant differences in BCVA improvement or CMT reduction between the two groups ( p > 0.05 ). The mean number of IVR injections was significantly lower in the IVR + CaD group than the IVR group (5.4 ± 1.1 vs. 6.7 ± 1.6 injections, p < 0.05 ) during 1 year of treatment. No adverse events were noted in either group. Conclusions. Compared to IVR alone, the addition of oral CaD to IVR in DME patients was safe and effective for improving visual function and restoring the retinal anatomy and was associated with the need for fewer injections.

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Anti-VEGF versus dexamethasone implant (Ozurdex) for the management of Centre involved Diabetic Macular Edema (CiDME): a randomized study

Cited by 12 publications

References 19 publications

Efficacy and safety profile of intravitreal dexamethasone implant versus antivascular endothelial growth factor treatment in diabetic macular edema: a systematic review and meta-analysis

Efficacy and safety profile of intravitreal dexamethasone implant versus antivascular endothelial growth factor treatment in diabetic macular edema: a systematic review and meta-analysis

Diabetic Macular Oedema Guidelines: An Australian Perspective

Intravitreal Ranibizumab Alone or in Combination with Calcium Dobesilate for the Treatment of Diabetic Macular Edema in Nonproliferative Diabetic Retinopathy Patients: 12-Month Outcomes of a Retrospective Study

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