Dexamethasone implant (0.7 mg) in Indian patients with macular edema: Real-life scenario

Nagpal, Manish; Mehrotra, Navneet; Juneja, Rakesh; Jain, Hardik

doi:10.4103/tjo.tjo_62_17

Cited by 19 publications

(27 citation statements)

References 14 publications

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“…[29][30][31] Currently available scientific evidence strongly suggested that DEX implant significantly improved both functional and anatomical outcomes in either naïve or previously treated DME patients. [13][14][15][16][17][18][19] Moreover, it has been reported that a significant improvement in both anatomical and functional outcomes was observed as soon as the first days after the after DEX implant injection, 20 even in eyes with persistent DME. 32 In addition, different studies have assessed the effects of DEX implants in patients with persistent DME, showing its efficacy in both improving BCVA and reducing retinal thickness.…”

Section: Discussionmentioning

confidence: 99%

“…Ozurdex (Allergan Inc, Irvine, CA, USA) is a sustained release and biodegradable intravitreal implant that has been shown to be an effective treatment for DME in clinical and real-life studies. 13–19 In addition, Ozurdex showed a rapid and progressive reduction in CRT after 3 days. 20…”

Section: Introductionmentioning

confidence: 95%

“…11,12 Ozurdex (Allergan Inc, Irvine, CA, USA) is a sustained release and biodegradable intravitreal implant that has been shown to be an effective treatment for DME in clinical and real-life studies. [13][14][15][16][17][18][19] In addition, Ozurdex showed a rapid and progressive reduction in CRT after 3 days. 20 Unfortunately, none of these studies addressed the question of whether an early change to Ozurdex, in poorly responsiveness anti-VEGF patients, would mean a better anatomical and/or functional response.…”

Section: Introductionmentioning

confidence: 99%

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Early versus late switch: How long should we extend the anti-vascular endothelial growth factor therapy in unresponsive diabetic macular edema patients?

Hernández-Martínez

Delgado

Silva

et al. 2019

European Journal of Ophthalmology

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Purpose: To compare the results of early versus late switch to the dexamethasone intravitreal implant Ozurdex® in patients with diabetic macular edema who had a poor response to vascular endothelial growth factor inhibitors. Methods: Retrospective and single-center study conducted, in a real setting, on consecutive diabetic macular edema patients who were switch to an intravitreal dexamethasone implant after a poor response to anti-vascular endothelial growth factor treatment. Study sample was divided into two groups: (1) early-switch group, included those eyes who received three anti-vascular endothelial growth factor injections before switch and (2) late-switch group, included those eyes that received six or more anti-vascular endothelial growth factor injections before switch. The primary end-point was the difference in mean change in best-corrected visual acuity and in central subfoveal thickness. Results: A total of 69 (31 early-switch group and 38 late-switch group) eyes were included. In the early-switch group, median (25–75 quartile range) best-corrected visual acuity significantly increase from 0.2 (0.2–0.5) at baseline to 0.4 (0.3 –0.7) at month 24 (p = 0.0043). Whereas, in the late-switch group, best-corrected visual acuity did not increase (p = 0.8602). Central subfoveal thickness was significantly reduced in both early- and late-switch groups, p = 0.0002 and 0.0038, respectively. The proportion of eyes obtaining a central subfoveal thickness reduction ⩾ 10% was significantly greater in the early-switch group than in the late-switch group (71.0% vs 47.4%, respectively, p = 0.0498). Three (9.7%) and 10 (26.3%) eyes have developed ocular hypertension during the study in the early- and late-switch groups, respectively, p = 0.0816. Conclusion: Early switch to Ozurdex in patients who did not adequately respond to anti-vascular endothelial growth factor therapy provided better functional and anatomical outcomes.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 95%

Section: Introductionmentioning

confidence: 99%

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Early versus late switch: How long should we extend the anti-vascular endothelial growth factor therapy in unresponsive diabetic macular edema patients?

Hernández-Martínez

Delgado

Silva

et al. 2019

European Journal of Ophthalmology

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“…13 Ozurdex V R (Allergan Inc., Irvine, CA, USA) is a sustained release and biodegradable dexamethasone intravitreal (DEX) implant that has been shown to be an effective treatment for DME in clinical and real-life studies. [14][15][16][17][18][19][20][21][22] Although limited, we have some currently available evidence suggesting that, in patients who did not adequately respond to 3-monthly anti-VEGF injections, DEX may be a valuable option. [22][23][24][25] Herna´ndez Mart ınez et al 22 compared, in a retrospective study, the effect of DEX on BCVA and central retinal thickness (CRT) in patients who were switched to DEX due to poor response to anti-VEGF therapy.…”

Section: Introductionmentioning

confidence: 99%

Results of dexamethasone intravitreal implant (Ozurdex) in diabetic macular edema patients: Early versus late switch

Ruiz‐Medrano

Rodríguez-Leor

Almazán

et al. 2020

European Journal of Ophthalmology

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Purpose To assess the functional and anatomical outcomes of intravitreal dexamethasone implant Ozurdex® in eyes with diabetic macular edema that did not adequately respond to vascular endothelial growth factor inhibitors. Methods Multicenter, retrospective, and real-life case series study conducted on consecutive diabetic macular edema patients who underwent treatment with one or more dexamethasone implant injections and were followed up for a minimum of 12 months. Subjects were divided into three groups: I—naïve patients, II—previously treated eyes that received three intravitreal antivascular endothelial growth factor inhibitors injections before the study (early switch), and III—previously treated eyes that received >3 intravitreal antivascular endothelial growth factor inhibitors injections before the study (late switch). Primary endpoints were best-corrected visual acuity and central retinal thickness at month 12. Results A total of 129 eyes (21 naïve and 108 previously treated, Group II: 32 and Group III: 76) were included. At month 12, best-corrected visual acuity significantly improved from 0.27 ± 0.23 and 0.31 ± 0.22 at baseline to 0.36 ± 0.25 and 0.37 ± 0.23 at month 12 in naïve and previously treated eyes, respectively, and p = 0.0063 and 0.0060, respectively. Central retinal thickness, in naïve and previously treated eyes, was significantly reduced from 483.0 ± 143.4 and 431.3 ± 115.5 µm, at baseline, to 278.8 ± 72.1 and 269.3 ± 66.2 µm, at month 12, respectively, and p < 0.0001 each, respectively. Best-corrected visual acuity improvement was significantly greater in both absolute and percentage values, p = 0.0393 and 0.0118, respectively, in Group II than in Group III. Conclusion In eyes with insufficient response to antivascular endothelial growth factor inhibitors, switching to dexamethasone at the time to 3-monthly antivascular endothelial growth factor inhibitors injections provided better functional outcomes than those that received >3 antivascular endothelial growth factor inhibitors injections.

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“…Besides the good efficacy and safety profile of DEX reported in the clinical trials [ 100 – 111 ], the efficacy and safety of Ozurdex® for the treatment of DME have been recently evaluated in clinical and real-life studies [ 113 – 120 ]. In summary, the results of these studies clearly indicated that Ozurdex® significantly improved the functional (visual acuity) and anatomic (retinal thickness) outcomes, not only in the midterm [ 113 , 114 , 119 , 120 ] but also in the long term [ 115 – 118 ], in both naïve and previously treated DME patients, but naïve eyes consistently fared better [ 113 – 118 , 120 ].…”

Section: Treatment Strategies Of Dmementioning

confidence: 99%

Intravitreal Therapy for Diabetic Macular Edema: An Update

Furino

Boscia

Reibaldi

et al. 2021

Journal of Ophthalmology

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Diabetic macular edema (DME) represents a prevalent and disabling eye condition. Despite that DME represents a sight-threatening condition, it is also among the most accessible to treatment. Many different treatment options including photocoagulation, intravitreal medical treatment (either vascular endothelial growth factor inhibitors or corticosteroids therapies), and surgical removal are currently available. Although laser has been considered as the gold standard for many years, over the past several years vascular endothelial growth factor inhibitors (anti-VEGFs) have become first-line therapy. However, many patients do not adequately respond to them. With the development of sustained-release corticosteroid devices, steroids have gained a presence in the management of the DME. We review and update the role of anti-VEGF and intravitreal sustained-release corticosteroid management of DME. According to the currently available scientific evidence, the choice of one anti-VEGF over another critically depends on the baseline best-corrected visual acuity (BCVA). While aflibercept may be the drug of choice in low baseline BCVA, the three anti-VEGFs (bevacizumab, ranibizumab, and aflibercept) provided similar functional outcomes when the baseline BCVA was higher. DEX implants are a valuable option for treating DME, although they are usually seen as a second choice, particularly in those eyes that have an insufficient response to anti-VEGF. The new evidence suggested that, in eyes that did not adequately respond to anti-VEGF, switching to a DEX implant at the time to 3 monthly anti-VEGF injections provided better functional outcomes.

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Dexamethasone implant (0.7 mg) in Indian patients with macular edema: Real-life scenario

Cited by 19 publications

References 14 publications

Early versus late switch: How long should we extend the anti-vascular endothelial growth factor therapy in unresponsive diabetic macular edema patients?

Early versus late switch: How long should we extend the anti-vascular endothelial growth factor therapy in unresponsive diabetic macular edema patients?

Results of dexamethasone intravitreal implant (Ozurdex) in diabetic macular edema patients: Early versus late switch

Intravitreal Therapy for Diabetic Macular Edema: An Update

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