Akin Cakir1, Burak Erden2, Selim Bolukbasi2, Alper Halil Bayat2, Seyma Gulcenur Ozturan2, Mustafa Nuri Elcioglu2. 1. Department of Opthalmology, Okmeydanı Research and Training Hospital, Darülaceze Cad. No:25 Şişli, 34367, Istanbul, Turkey. dracakir@gmail.com. 2. Department of Opthalmology, Okmeydanı Research and Training Hospital, Darülaceze Cad. No:25 Şişli, 34367, Istanbul, Turkey.
Abstract
PURPOSE: This study evaluates the effectiveness of a single-dose dexamethasone implant (DI) as an auxiliary therapy to continued intravitreal ranibizumab (IVR) treatment in patients with persistent diabetic macular edema (DME). METHODS: Twenty-five pseudophakic eyes of 25 patients with DME who underwent a single injection of DI as an adjuvant therapy following an IVR loading dose were examined retrospectively. All patients were treatment naive and had a poor response to a loading dose of three consecutive monthly IVR injections. IVR treatments were continued pro re nata after the DI. The main outcome measures were changes in best-corrected visual acuity (BCVA) and central macular thickness (CMT) at 1, 3, 6 and 8 months post-DI treatment. RESULTS: After the IVR loading dose, the mean BCVA and CMT were 0.9 ± 0.6 LogMAR and 478.2 ± 107.8 µm, respectively. One month after the DI, the mean BCVA and CMT had improved to 0.6 ± 0.4 LogMAR (p = 0.005) and 313.8 ± 62.7 µm (p < 0.001), respectively. This improvement was maintained with mean 0.8 ± 0.8 IVR injections throughout the follow-up period. The final mean BCVA and CMT were 0.5 ± 0.5 LogMAR and 298.4 ± 71.5 µm. Subgroup analyses revealed that different DME types did not have any effect on CMT or BCVA improvement (p = 0.188, p = 0.136; respectively). CONCLUSION: Adding DI results in rapid anatomical and visual improvement in patients who respond poorly to an IVR loading dose. Improvements may be maintained with additional IVR in follow-up.
PURPOSE: This study evaluates the effectiveness of a single-dose dexamethasone implant (DI) as an auxiliary therapy to continued intravitreal ranibizumab (IVR) treatment in patients with persistent diabetic macular edema (DME). METHODS: Twenty-five pseudophakic eyes of 25 patients with DME who underwent a single injection of DI as an adjuvant therapy following an IVR loading dose were examined retrospectively. All patients were treatment naive and had a poor response to a loading dose of three consecutive monthly IVR injections. IVR treatments were continued pro re nata after the DI. The main outcome measures were changes in best-corrected visual acuity (BCVA) and central macular thickness (CMT) at 1, 3, 6 and 8 months post-DI treatment. RESULTS: After the IVR loading dose, the mean BCVA and CMT were 0.9 ± 0.6 LogMAR and 478.2 ± 107.8 µm, respectively. One month after the DI, the mean BCVA and CMT had improved to 0.6 ± 0.4 LogMAR (p = 0.005) and 313.8 ± 62.7 µm (p < 0.001), respectively. This improvement was maintained with mean 0.8 ± 0.8 IVR injections throughout the follow-up period. The final mean BCVA and CMT were 0.5 ± 0.5 LogMAR and 298.4 ± 71.5 µm. Subgroup analyses revealed that different DME types did not have any effect on CMT or BCVA improvement (p = 0.188, p = 0.136; respectively). CONCLUSION: Adding DI results in rapid anatomical and visual improvement in patients who respond poorly to an IVR loading dose. Improvements may be maintained with additional IVR in follow-up.
Authors: David S Boyer; Young Hee Yoon; Rubens Belfort; Francesco Bandello; Raj K Maturi; Albert J Augustin; Xiao-Yan Li; Harry Cui; Yehia Hashad; Scott M Whitcup Journal: Ophthalmology Date: 2014-06-04 Impact factor: 12.079
Authors: Quan Dong Nguyen; David M Brown; Dennis M Marcus; David S Boyer; Sunil Patel; Leonard Feiner; Andrea Gibson; Judy Sy; Amy Chen Rundle; J Jill Hopkins; Roman G Rubio; Jason S Ehrlich Journal: Ophthalmology Date: 2012-02-11 Impact factor: 12.079
Authors: Gui-shuang Ying; Maureen G Maguire; Ebenezer Daniel; Frederick L Ferris; Glenn J Jaffe; Juan E Grunwald; Cynthia A Toth; Jiayan Huang; Daniel F Martin Journal: Ophthalmology Date: 2015-09-15 Impact factor: 12.079
Authors: Allen C Ho; Ingrid U Scott; Stephen J Kim; Gary C Brown; Melissa M Brown; Michael S Ip; Franco M Recchia Journal: Ophthalmology Date: 2012-08-20 Impact factor: 12.079
Authors: Frederick L Ferris; Maureen G Maguire; Adam R Glassman; Gui-Shuang Ying; Daniel F Martin Journal: JAMA Ophthalmol Date: 2017-02-01 Impact factor: 7.389
Authors: Elena Pacella; Anna Rita Vestri; Roberto Muscella; Maria Rosaria Carbotti; Massimo Castellucci; Luigi Coi; Paolo Turchetti; Fernanda Pacella Journal: Clin Ophthalmol Date: 2013-07-16