Dexamethasone Intravitreal Implant in Diabetic Macular Edema: Real-Life Data from a Prospective Study and Predictive Factors for Visual Outcome

Dexamethasone Intravitreal Implant in Diabetic Macular Edema: Real-Life Data from a Prospective Study and Predictive Factors for Visual Outcome

Introduction The purpose of the study was to evaluate the long-term anatomical and functional outcomes in patients with diabetic macular edema (DME) treated with intravitreal dexamethasone implant and to determine the predictive factors for the final visual outcome. Methods The study included 54 pat...

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Bibliographic Details
Published in:Diabetes therapy Vol. 8; no. 6; pp. 1393 - 1404
Main Authors: Chatziralli, Irini, Theodossiadis, Panagiotis, Parikakis, Efstratios, Dimitriou, Eleni, Xirou, Tina, Theodossiadis, George, Kabanarou, Stamatina Α.
Format: Journal Article
Language:English
Published: Cheshire Springer Healthcare 01-12-2017
Springer
Springer Nature B.V
Subjects:
Cardiology
Central nervous system depressants
Clinical outcomes
Dexamethasone
Diabetes
Diabetic retinopathy
Dropsy
Edema
Endocrinology
Eye diseases
Internal Medicine
Medical research
Medicine
Medicine & Public Health
Medicine, Experimental
Original Research
Patient outcomes
Povidone
Steroids
Transplants & implants
Vascular endothelial growth factor
Visual perception
Visual acuity
Dexamethasone
Optical coherence tomography
Predictive factors
Diabetic macular edema
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Summary:Introduction The purpose of the study was to evaluate the long-term anatomical and functional outcomes in patients with diabetic macular edema (DME) treated with intravitreal dexamethasone implant and to determine the predictive factors for the final visual outcome. Methods The study included 54 patients with DME refractory to previous antivascular endothelial growth factor (anti-VEGF) who were treated with intravitreal dexamethasone implant. Predictive factors for visual outcome were assessed. In addition, the change in best-corrected visual acuity (BCVA) and the percentage of patients with edema resolution were evaluated. Results At the end of the 12-month follow-up, patients with DME gained + 5.2 letters (about 1 Snellen line), while 57.4% of patients presented total resolution of macular edema. Negative predictive factors for the final visual outcome were found to be increasing age, increasing macular thickness, phakic status, the presence of intraretinal fluid, hyperreflective foci, hard exudates, as well as external limiting membrane and ellipsoid zone disruption. The mean number of injections was 2.1. Conclusions The various predictive factors that determine the visual outcome and possibly define patient prognosis after dexamethasone intravitreal implant in DME cases have been studied. The long follow-up showed that dexamethasone intravitreal implant seems to be a safe and effective treatment for this disease, requiring a limited number of injections.
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ISSN:1869-6953
1869-6961
DOI:10.1007/s13300-017-0332-x