An Evaluation of the Efficacy of Intravitreal DexamethasoneImplant in Treatment-Naive and Treatment-Resistant DiabeticMacular Edema Patients: A Retrospective Research

Uzlu D., Gürsoy N., Erdöl H., Akyol N., Kola M., Gunay M.

Türkiye Klinikleri Oftalmoloji Dergisi, vol.31, no.1, pp.26-33, 2022 (Peer-Reviewed Journal) identifier


Objective: To evaluate the effectiveness of single-dose intravitreal dexamethasone implant in treatment-resistant and -naive diabetic macular edema patients. Material and Methods: Twenty-five eyes of 18 diabetic patients receiving intravitreal dexamethasone between January 2017 and March 2020 were included in the study. Changes in best corrected visual acuity (BCVA), intraocular pressure, and retinal and choroidal thickness were determined before, and 1, 4, and 6 months after treatment. Results: Eleven of the 25 eyes had not previously received any anti-vascular endothelial growth factor injection, while the other 14 eyes had received a mean 9.28±6.83 anti-vascular endothelial growth factor injections. Initial BCVA was 0.81±0.46 logMAR, compared to 0.65±0.44 logMAR at 1 month, 0.66±0.45 logMAR at 4, and 0.78±0.44 logMAR at 6. While a significant difference was observed between initial and 1st month BCVA (p=0.005) a statistically significant difference was not observed between initial and 6th month BCVA values (p>0.05). Mean retinal thickness was 490.56±186.56 μm at baseline, 301.24±139.63 μm at 1 month, 304.84±129.97 μm at 4 month and 378.44±212.33 μm at 6 month. Retinal thickness decreased significantly at 1, 4, and 6 months compared to baseline (p<0.05). Initial mean subfoveal choroidal thickness was 300.32±32.78 μm, decreasing to 263.68±30.87 μm at 1 month, 258.44±31.5 μm at 4 month, and 268.20±40.10 μm at 6 month. The changes observed in choroidal thickness at 1, four and 6 months compared to baseline were statistically significant (p<0.05). A statistically significant difference in retinal thickness between patients with treatment resistant edema and patients with naive edema was only observed in the 1st month (p=0.001). Conclusion: Significant decreases in retinal and choroidal thickness were observed both in patients with diabetic macular edema refractory to anti-VEGF therapy and in treatment-naive diabetic macular edema patients administered dexamethasone, while visual acuity increased, particularly in the 1st and 4th months.