Change in macular thickness in a case of refractory diabetic macular edema with dexamethasone intravitreal implant in comparison to intravitreal bevacizumab: A case report

Abstract

We report on the significant improvement of central macular thickness in a case of clinically significant macular edema after dexamethasone 0.7 mg sustained-release intravitreal implant (Ozurdex®; Allergan, Inc, Irvine, CA, USA). Patient presented to us with persistent clinically significant macular edema (CSME) in both eyes. Right eye received dexamethasone implant and left eye received two intravitreal bevacizumab injections 1.25 mg/0.05 mL (Avastin®; Genentech Inc., South San Francisco, CA, USA) with an interval of four weeks. After six weeks of follow-up, dexamethasone implant in the right eye showed normal macular thickness whereas persistent macular edema (ME) was found even after second intravitreal bevacizumab injection in the left eye.

Preliminary results of an intravitreal dexamethasone implant (Ozurdex®) in patients with persistent diabetic macular edema

“…The results that Ozurdex has a beneficial short-term effect on VA and retinal thickness are not surprising, and consistent with previous works 13–17,22–24. Perhaps the association of this treatment intervention and other therapeutic strategies may help better the outcomes for this pathology 20,21. Similar efficacy and safety studies are certainly needed, with a greater number of patients and for a longer period of time.…”

Intravitreal Injection of Ozurdex® Implant in Patients with Persistent Diabetic Macular Edema, with Six-Month Follow-Up

“…In addition, in the recent years, it has been proposed that the association of dexamethasone with other therapeutic strategies may produce significant structural retinal improvements in these patients. [30][31][32] Although our findings further provide evidence for the use of Ozurdex in DME, there are some limitations to our data interpretations. First, the number of eyes examined is relatively low with a short follow-up period, and hence, it is difficult to reach definitive conclusions.…”

Dexamethasone Implants in Patients with Naïve or Refractory Diffuse Diabetic Macular Edema

“…In addition, the mean best-corrected VA (BCVA) improved to 0.52 logMAR, 0.44 logMAR and 0.51 logMAR (p = 0.0001) after 1, 3 and 6 months, respectively. Other smaller studies conducted in lower numbers of refractory patients treated with the DEX implant and case reports have showed similar improvements in BCVA values and CMT, with peak efficacy observed at months 1-3, and then a slow decrease from month 4 to 6 [24,26,27,28,29,30]. …”