An eighteen-month follow-up study on the effects of Intravitreal Dexamethasone Implant in diabetic macular edema refractory to anti-VEGF therapy

• 作者: Alessandra Mastromatteo Anna Carnovale Antonella Mollicone Elena Pacella Fernanda Pacella Giovanna Tarquini Maria Rosaria Romano Paolo Turchetti
• 来源期刊: 国际眼科杂志：英文版
• 学科: 医学
• 年，卷（期）: 2016,（10）
• 页码范围: 1427-1432
• 页数: 6页
• 分类号: R77

摘要

AIM: To evaluate the long-term efficacy and safety of dexamethasone implants in subjects affected by diabetic macular edema(DME) resistant to anti-vascular endothelial growth factor(VEGF) therapy.METHODS: Thirty-two DME patients were enrolled.A700 microgram slow release Intravitreal Dexamethasone Implant(Ozurdex~) was placed in the vitreous cavity.All patients were followed for 18 mo.Best-corrected visual acuity(BCVA) measured with Early Treatment Diabetic Retinopathy Study(ETDRS) and central macular thickness(CMT) exams were carried out at baseline(T0)and after 1(T1),3(T3),4(T4),6(T6),9(T9),12(T12),15(T15),and 18mo(T18) post injection. RESULTS: Repeated measures ANOVA showed an effect of treatment on ETDRS(P<0.0001).Post hoc analyses revealed that ETDRS values were significantly increased at T1,T3,T4,T9,and T15(P <0.001) as compared to baseline value(T0).At T6,T12,and T18,ETDRS values were still statistically higher than baseline(P<0.001 vs T0).However,at these time points,we observed a trend to return to baseline conditions.ANOVA also showed an effect of treatment(P <0.0001).CMT decreased significantly at T1,T3,T4,T9,and T15(P<0.001).At T6(P<0.01),T12 and T18(P<0.001) CMT was also significantly lower than T0 although a trend to return to the baseline conditions was also observed.CONCLUSION: Our findings demonstrate that Intravitreal Dexamethasone Implant is a good option to improveBCVA and CMT in DME patients resistant to anti-VEGF therapy.Our data also show that the use of drugs administered directly into the vitreous allows achieving appropriate and long-lasting concentration at the site of disease without systemic side effects.