Dexamethasone implant in pseudophakic and nonglaucomatous subgroup of diabetic macular edema patients: a real life experience

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Purpose:To evaluate the efficacy of intravitreal dexamethasone implant (IDI) for the treatment of persistent diabetic macular edema (DME) in a subgroup of pseudophakic and nonglaucomatous eyes over a 12-month follow-up period.Methods:This was a retrospective, interventional study. Patients with persistent DME who were pseudophakic and did not have a glaucoma or ocular hypertension history, or a family history of glaucoma, were included. After an initial IDI injection, reinjections were performed on an as-needed basis. Changes in best-corrected visual acuity (BCVA), central retinal thickness (CRT), intraocular pressure (IOP), and number of injections at month 12 were evaluated.Results:The study included 50 eyes of 43 patients. Mean BCVA at baseline and at months 1, 3, 6, 9, and 12 were 0.22 ± 0.17, 0.31 ± 0.21, 0.25 ± 0.17, 0.25 ± 0.17, and 0.29 ± 0.19 Snellen equivalent, respectively (p<0.05 for all). Mean CRT at baseline and at months 1, 3, 6, 9, and 12 were 606 ± 202 μm, 330 ± 97 μm, 347 ± 104 μm, 405 ± 149 μm, 383 ± 129 μm, and 397 ± 144 μm, respectively (p<0.0001 for all). Seven of the 50 eyes (14 %) showed an increase in IOP of ≥10 mm Hg and only 2 of them (4%) needed chronic antiglaucoma medication. The mean number of injections at month 12 was 2.04 ± 0.5.Conclusions:In pseudophakic and nonglaucomatous eyes with DME, IDI was found to be beneficial in regard to visual and anatomic success and seemed safe in this selected group of patients.

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