Journal
RETINA-THE JOURNAL OF RETINAL AND VITREOUS DISEASES
Volume 39, Issue 1, Pages 44-51Publisher
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/IAE.0000000000002196
Keywords
diabetic macular edema; naive eyes; refractory eyes; dexamethasone implant; visual outcomes; anatomical outcomes
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Purpose: To investigate efficacy and safety of repeated dexamethasone (DEX) implants over 24 months, in diabetic macular edema (DME) eyes that were treatment naive compared with eyes refractory to anti-vascular endothelial growth factor treatment, in a real-life environment. Methods: This multicenter international retrospective study assessed best-corrected visual acuity and central subfield thickness (CST) of naive and refractory eyes to antivascular endothelial growth factor injections treated with dexamethasone implants. Safety data (intraocular pressure rise and cataract surgery) were recorded. Results: A total of 130 eyes from 125 patients were included. Baseline best-corrected visual acuity and CST were similar for naive (n = 71) and refractory eyes (n = 59). Both groups improved significantly in vision after 24 months (P, 0.001). However, naive eyes gained statistically significantly more vision than refractory eyes (+ 11.3 +/- 10.0 vs. 7.3 +/- 2.7 letters, P = 0.01) and were more likely to gain >= 10 letters (OR 3.31, 95% CI 1.19-9.24, P = 0.02). At 6, 12, and 24 months, CST was significantly decreased compared with baseline in both naive and refractory eyes; however, CST was higher in refractory eyes than in naive eyes (CST 279 +/- 61 vs. 313 +/- 125 mu m, P = 0.10). Conclusion: Over a follow-up of 24 months, vision improved in diabetic macular edema eyes after treatment with dexamethasone implants, both in eyes that were treatment naive and eyes refractory to anti-vascular endothelial growth factor treatment; however, improvement was greater in naive eyes.
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