Intravitreal Dexamethasone Implant in Patients with Persistent Diabetic Macular Edema

Abstract

Purpose: To evaluate the effects of a single injection of Ozurdex over 6 months in eyes with persistent diabetic macular edema (DME). Methods: In this retrospective interventional study, 9 patients with decreased visual acuity, as a result of persistent DME, received Ozurdex (intravitreal dexamethasone implant 0.7 mg). Main outcome measures included changes in best-corrected visual acuity (BCVA) and central retinal thickness (CRT). Results: Nine eyes of 9 patients (5 males, 4 females; mean age 58 years) were included in the analysis. The mean duration of DME was 49.9 months (range 24–85). All patients had undergone previous treatments for DME (intravitreal injection of anti-vascular endothelial growth factor, steroids or laser photocoagulation) before entering the study. At baseline, the mean BCVA was 0.74 ± 0.33 logMAR, and the mean CRT was 502 ± 222.16 µm. The mean BCVA was unchanged on the third day (0.74 ± 0.38 logMAR, p = 0.5), improved to 0.62 ± 0.32 logMAR (p = 0.02), 0.59 ± 0.26 logMAR (p = 0.02) and 0.63 ± 0.38 logMAR (p = 0.6) after the first, third and fourth months, respectively, and decreased again to 0.73 ± 0.35 logMAR (p = 0.4) at 6 months. The mean CRT improved to 397 ± 115.31 µm (p = 0.17), 271 ± 99.97 µm (p = 0.007), 325 ± 133.05 µm (p = 0.03) and 462 ± 176.48 µm (p = 0.36) on the third day and after 1, 3 and 4 months of follow-up and then increased again to 537 ± 265.42 µm (p = 0.33) at 6 months. Eight patients needed retreatments in the sixth month. One eye developed a transient intraocular pressure (IOP) increase 1 month after injection, which was successfully managed with topical IOP-lowering medication. Conclusion: In eyes with persistent DME, Ozurdex produces improvement in BCVA and CRT as soon as the first days after the injection. Such improvement is maintained until the fourth month.

Penetration Force, Geometry, and Cutting Profile of the Novel and Old Ozurdex Needle: The MONO Study

“…The novel DDS applicator is a well-established applicator system to apply sustained release of DEX-implants into the vitreous cavity. With favorable confidence in intravitreal DEX injections (17,18,19) among treating physicians, the sharper novel DDS needle will increase in use as confirmed by our measurements in this experimental study.…”

Theeffects and safety of intravitreal triamcinolone injections in the treatment of diabetic macular edema

“…Even dexamethasone steroid implants (Ozur- 1 week dex), currently being introduced in DME treatment, may not have a longer duration than triamcinolone acetonide injections. 19 Fluocinolone acetonide intravitreal implants (Iluvien) should be effective up to 36 months after intravitreal injection, but, like Ozurdex, will not be available in the near future for most diabetic patients due to its cost, which is not reimbursed by national health insurance in many countries. 20 As there was no control group in the present study, it cannot conclusively be stated that the remission of diabetic edema was in each case the effect of the therapy; there is a chance that it might have occurred in the natural course of the disease.…”

Intravitreal Dexamethasone Implant in Patients with Persistent Macular Edema of Variable Etiologies

“…There is little evidence in the published literature of the effect of DEX-DDS in the treatment of edema persisting following other treatments [28,29,30,31,32,33]. The purpose of our study was to examine the effect of DEX-DDS in patients with severely recalcitrant CME that had a poor or short-term response to other treatment modalities.…”