Dexamethasone Intravitreal Implant for Treatment of Patients with Persistent Diabetic Macular Edema

Purpose: To report the 6-month anatomical and best-corrected visual acuity (BCVA) response after primary intravitreal dexamethasone implantation (Ozurdex (R)) in patients with refractory diabetic macular edema (DME). Methods: Retrospective review of the medical records of 58 patients with decreased visual acuity, due to refractory DME, who underwent a single injection of Ozurdex between November 2010 and January 2012, at the Instituto de Microcirurgia Ocular, Barcelona, Spain. Results: At baseline, the mean foveal thickness (FT) was 543.24 +/- 156.51 mu m. Mean (+/- SD) values of FT did decrease to 346.82 +/- 123.74 mu m at month 1 and 341.12 +/- 129.64 mu m at month 3. Data on the 6-month followup showed a mild increase to 420.16 +/- 152.15 mu m. All of the FT reduction outcomes were statistically significant, with respect to baseline data (p = 0.0001). The baseline BCVA data was 0.66 +/- 0.36 logarithm of the minimum angle of resolution (logMAR). The mean BCVA improved to 0.52 +/- 0.32 logMAR (p = 0.0001) and 0.44 +/- 0.27 logMAR (p = 0.0001) after 1 and 3 months, respectively. At the last visit (6-month follow-up), the mean BCVA increased to 0.51 +/- 0.31 logMAR (p = 0.0001). Conclusions: In this study, intravitreal treatment with a dexamethasone implant safely reduced DME and improved visual acuity in a difficult-to-treat patient population with long-standing refractory DME. (C) 2013 S. Karger AG, Basel