VISUAL OUTCOMES IN PATIENTS WITH DIABETIC MACULAR EDEMA TREATED WITH DEXAMETHASONE IMPLANT IN ROUTINE CLINICAL PRACTICE/ISHOD VIDNE OSTRINE U BOLESNIKA S DIJABETICKIM MAKULARNIM EDEMOM LIJECENIM IMPLANTATOM DEKSAMETAZONA U RUTINSKOJ KLINICKOJ PRAKSI

• Published in: Acta clinica Croatica (Tisak) Vol. 60; no. 4; p. 602
• Main Authors: Urbancic, Mojca, Topcic, Ivana Gardasevic, Matovic, Katja
• Format: Journal Article
• Language: English
• Published: Klinicki bolnicki centar Sestre milosrdnice 01-12-2021
• Subjects: Causes of; Dexamethasone; Diabetic retinopathy; Dosage and administration; Drug therapy; Eye diseases; Patient outcomes; Slovenia
• DOI: 10.20471/acc.2021.60.04.06
• ISSN: 0353-9466

The aim was to evaluate visual outcomes of the real-life usage of dexamethasone (DEX) implants in diabetic macular edema (DME) patients and evaluate the possible additional visual acuity (VA) gain with combined treatment. We retrospectively reviewed medical records of DME patients treated with DEX implants. The mean best-corrected visual acuity (BCVA) and mean central retinal thickness (CRT) at baseline and one year were compared. BCVA improved from 58.4[+ or -]14.9 letters at baseline to 62.4[+ or -]14.5 letters at one-year evaluation (p=0.002). The mean change in BCVA was 5.2[+ or -]11.1 letters. CRT decreased from 485.7[+ or -]146.3 [micro]m at baseline to 391.5[+ or -]129.0 [micro]m at one year (p<0.001). The mean change in CRT was -89.6[+ or -]143.3 [micro]m. Patients received a mean of 2.0[+ or -]0.7 DEX implants. Study eyes were also divided into a group receiving DEX implant monotherapy and a group receiving DEX implant and vascular endothelial growth factor inhibitor (anti-VEGF) therapy. Changes in BCVA and CRT and the number of DEX implant injections were compared between the two groups. No difference in VA gain was found between the eyes receiving monotherapy and the eyes receiving combined treatment. In conclusion, DEX implant therapy was effective in gaining vision in DME patients. No additional VA gain was achieved with combined treatment. Key words: Diabetic macular edema; Dexamethasone implant; Routine clinical practice Cilj je bio procijeniti ishod vidne ostrine (VA) uz primjenu implantata deksametazona (DEX) u stvarnom zivotu kod bolesnika s dijabetickim makularnim edemom (DME) te moguce dodatno poboljsanje VA uz kombinirano lijecenje. Proveden je retrospektivni pregled medicinske dokumentacije bolesnika lijecenih implantatom DEX zbog DME. Usporedivane su srednje vrijednosti najbolje korigirane vidne ostrine (BCVA) i srednje vrijednosti centralne debljine mreznice (CRT) na pocetku i nakon godinu dana. BCVA se poboljsala s 58,4[+ or -]14,9 slova u pocetnoj procjeni na 62,4[+ or -]14,5 slova pri procjeni nakon godinu dana (p=0,002). Srednja promjena BCVA iznosila je 5,2[+ or -]11,1 slova. CRT se smanjio s 485,7[+ or -]146,3 [micro]m na pocetnoj razini na 391,5[+ or -]129,0 [micro]m nakon godinu dana (p<0,001). Srednja promjena CRT bila je -89,6[+ or -]143,3 [micro]m. Bolesnici su primili u prosjeku 2,0[+ or -]0,7 implantata DEX. Oci su podijeljene u skupinu koja je primala monoterapiju implantatom DEX i skupinu koja je primala kombinaciju implantata DEX i blokatora vaskularnog endotelnog faktora rasta (anti-VEGF). Promjene u BCVA i CRT te broj injekcija implantata DEX usporedene su izmedu dviju skupina. Nije utvrdena razlika u poboljsanju VA izmedu dviju skupina. Zakljuceno je da je implantat DEX bio ucinkovit u poboljsanju vida kod bolesnika s DME. Kombiniranim lijecenjem nije postignuto dodatno poboljsanje VA. Kljucne rijeci: Dijabeticki makularni edem; Deksametazonski implantat; Rutinska klinicka praksa