Comparison of the Effect of Intravitreal Dexamethasone Implant in Vitrectomized and Nonvitrectomized Eyes for the Treatment of Diabetic Macular Edema

Çevik, Sadık Görkem; Yılmaz, Sami; Çevik, Mediha Tok; Akalp, Fatma Düriye; Avcı, Remzi

doi:10.1155/2018/1757494

Cited by 20 publications

(17 citation statements)

References 41 publications

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“…Both groups also shared the same pharmacokinetics after intravitreal placement of dexamethasone implants. Comparable visual/anatomical outcomes and rates of postinjection ocular hypertension were noted between vitrectomized and nonvitrectomized eyes after dexamethasone implant for DME in five previous clinical studies [31][32][33][34][35][36][37]. Dexamethasone implant injections also resulted in noticeable visual gain and foveal thickness reduction in vitrectomized patients with DME.…”

Section: Discussionmentioning

confidence: 69%

Comparison of Intravitreal Dexamethasone Implant and Ranibizumab in Vitrectomized Eyes with Diabetic Macular Edema

Wang

Huang

Chang

et al. 2021

Journal of Ophthalmology

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Purpose. This retrospective study aimed to compare the efficacy of intravitreal ranibizumab (IVR) and intravitreal dexamethasone implant (IDI) for pseudophakic vitrectomized eyes with diabetic macular edema (DME) in a single institution. Methods. Pseudophakic vitrectomized eyes with treatment-naïve center-involved DME were enrolled, with one eye in each patient. They were divided into two groups: one group receiving IDI every 3 to 4 months and another group receiving IVR using 3 monthly plus treat-and-extend injections, all with monthly follow-up for 6 months. Switch of intravitreal drugs or deferred macular laser was not allowed. Primary outcome measures included change in central foveal thickness (CFT) in 1 mm by spectral-domain optical coherence tomography and best-corrected visual acuity (BCVA) at Month 6. Results. Twenty-two eyes were included in the IDI group and 26 eyes in the IVR group. The baseline demographics, glycosylated hemoglobin level, intraocular pressure (IOP), BCVA, and CFT did not significantly differ ( p > 0.05 ). Compared to baseline data, CFT decreased and BCVA improved significantly after either IDI or IVR at Month 6 ( p < 0.05 ). Significantly better mean final BCVA (0.38 logMAR vs. 0.62 logMAR, p = 0.04 ), more mean visual gain (−0.30 logMAR vs. −0.15 logMAR, p = 0.02 ), lower mean final CFT (310.9 μm vs. 384.2 μm, p = 0.04 ), and larger mean CFT decrease (−150.0 μm vs. −60.1 μm, p = 0.03 ) were found in the IDI group compared to those in the IVR group. A smaller mean treatment number (2.6 vs. 5.6, p < 0.001 ) and higher rate of postinjection ocular hypertension requiring topical hypotensive agent therapy (27.3% vs. 0%, p = 0.0002 ) were demonstrated in the IDI group than those in the IVR group. Conclusion. We concluded that IDI and IVR can both effectively treat vitrectomized eyes with DME. Dexamethasone implants had significantly better visual/anatomical improvement, smaller treatment number, and higher rate of elevated IOP after injection than IVR in pseudophakic vitrectomized eyes with DME in a 6-month period.

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Section: Discussionmentioning

confidence: 69%

Comparison of Intravitreal Dexamethasone Implant and Ranibizumab in Vitrectomized Eyes with Diabetic Macular Edema

Wang

Huang

Chang

et al. 2021

Journal of Ophthalmology

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“…In their retrospective review of vitrectomized and nonvitrectomized groups including 24 eyes each, Medeiros et al 30 demonstrated that DEX had similar effectiveness in both groups in terms of visual improvement and decrease in CRT. Çevik et al 31 also reported that DEX was similarly effective in the treatment of DME in eyes with and without vitrectomy. Bastakis et al 32 reported that previous vitrectomy did not adversely affect the effectiveness of DEX in patients with refractory DME, and that the maximum effect was observed within the first 3 months in both vitrectomized and nonvitrectomized eyes.…”

Section: Discussionmentioning

confidence: 95%

Effectiveness of Intravitreal Dexamethasone Implant Treatment for Diabetic Macular Edema in Vitrectomized Eyes

Özdemir¹,

Hasanreisoğlu²,

Yuksel³

et al. 2019

tjo

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Objectives: To report the effectiveness and long-term outcomes of intravitreal dexamethasone implantation for diabetic macular edema (DME) in vitrectomized eyes Materials and Methods: Medical records of patients were retrospectively reviewed. Time of pars plana vitrectomy (PPV), PPV indications, interval between DEX injection and PPV, other intravitreal treatment prior to DEX application, best corrected visual acuity (BCVA), intraocular pressure (IOP), and central retinal thickness (CRT) measured by optical coherence tomography were recorded. Results: Seventeen eyes of 17 patients were included in the study. The mean follow-up after DEX injection was 21±2.4 months (12-43 months). The female/male ratio was 11/6. Mean age was 60.7 years (46-70 years). Sixteen eyes (94.1%) were pseudophakic at the time of DEX treatment. The most common indication for PPV was tractional retinal detachment (8 eyes, 47.1%). Ten eyes (58.8%) received a single injection and a total of 30 DEX implantations were performed. Mean BCVA was 0.77 logarithm of the minimum angle of resolution (logMAR) units before the first injection and improved to 0.64, 0.68 and 0.66 logMAR after 1, 3 and 6 months, respectively (p<0.01). CRT decreased significantly from 452 μm at baseline to 310, 368±34 and 375 μm after 1, 3 and 6 months, respectively (p<0.04). Mean IOP was 16±1.2 mmHg at baseline and 18.2, 18.8 and 18.5 mmHg after 1, 3, and 6 months (p>0.05). Two eyes (%8) received topical anti-glaucoma medication (IOP≥25 mmHg). Similar results were observed in eyes receiving repeated DEX injections. Conclusion: Intravitreal DEX injection treatment seems to be effective for improving BCVA and decreasing CRT in vitrectomized eyes with DME. This effect seemed to last for 6 months in most eyes, but maximized at 3 months. Patients with repeated injections often require injection before 6 months.

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“…The efficacy has been equal also in other studies even though the clearance of intravitreal drugs is accelerated after vitrectomy. 31…”

Section: Discussionmentioning

confidence: 99%

<p>Real Life Experience of Dexamethasone Implant in Refractory Diabetic Macular Oedema</p>

Karttunen

Nummelin

Kinnunen

2019

OPTH

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The purpose of this retrospective study was to examine the efficacy of dexamethasone implant in refractory diabetic macular oedema (DMO) in real life settings. Methods: In all, 24 eyes of 22 patients that required treatment with single or multiple intravitreal dexamethasone implants for refractory DMO were included in the study. Patients having macular oedema for another retinal disease were excluded from the study. The patient data were collected and analyzed retrospectively. As a demographic data age, gender, the type of diabetes and the duration of DMO were collected. Changes in central foveal thickness and the number of hyper reflective spots (HRS) were analyzed with Heidelberg SD-OCT. Furthermore, the best-corrected visual acuity (BCVA) and changes in the intraocular pressure (IOP) were measured. Results: In all, 50.0% of the eyes with baseline BCVA 0.45 (±2.4) lines in ETDRS LogMAR scale received only one implant during the follow-up of 332 (±79) days. At the end of the follow-up, BCVA was 0.26 (±2.0) lines. The other 50.0% of the eyes with baseline BCVA 0.64 (±3.0) lines received the second implant in 156 (±38) days. Central retinal thickness (CRT) at baseline was 333 (±44) μm in the eyes with only one implant and 497 (±125) μm in the eyes with 2 or more implants. IOP lowering medication was needed for 8.3% of the eyes. The decrease in the number of HRS was significant (8±17, p=0.048) in response to dexamethasone implantation. Conclusion: The dexamethasone implant is a useful treatment in refractory DMO and HRS seen in the OCT might indicate inflammation in the retina.

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Comparison of the Effect of Intravitreal Dexamethasone Implant in Vitrectomized and Nonvitrectomized Eyes for the Treatment of Diabetic Macular Edema

Cited by 20 publications

References 41 publications

Comparison of Intravitreal Dexamethasone Implant and Ranibizumab in Vitrectomized Eyes with Diabetic Macular Edema

Comparison of Intravitreal Dexamethasone Implant and Ranibizumab in Vitrectomized Eyes with Diabetic Macular Edema

Effectiveness of Intravitreal Dexamethasone Implant Treatment for Diabetic Macular Edema in Vitrectomized Eyes

<p>Real Life Experience of Dexamethasone Implant in Refractory Diabetic Macular Oedema</p>

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