Evaluation of the Results of the Application of the Dexamethasone Implant in the Treatment of Diabetic Macular Edema in Clinical Practice

Abstract

INTRODUCTION:  Evaluation of the efficacy and safety of the intravitreal dexamethasone implant in the treatment of persistent diabetic macular edema in clinical practice.

MATERIAL AND METHODS: Retrospective study of patients with diabetic macular edema treated with dexamethasone implantation between December 2010 and 2016. Efficacy analysis included visual acuity and central retinal thickness. Safety analysis included intraocular pressure and the need of hypotensive medication.

RESULTS: We selected 72 patients, half females, with a mean age of 67.6 years, already submitted to treatment. After the implantation, in the follow up periods of 1-2 months and 3-4 months, we documented an average improvement in visual acuity of 0.0944 logMAR (p=0.000) and 0.0804 logMAR (p=0.001) and in the central retinal thickness of 285.11μm (p=0.000) and 202.056μm (p=0.003). Concerning the safety, we documented an average worsening of the intraocular pressure of 1.972mmHg (p=0.000) and 0.946mmHg (p=0.032); 72.2% of patients needed hypotensive medication.

CONCLUSION: The dexamethasone implantation promoted a recovery of visual acuity and significant improvement of the retinal central thickness. We recorded increases in the intraocular pressure, controlled with hypotensive medication. It wasn’t possible to document the development and/or progression of cataract. This study has limitations; studies with additional patients and longer follow up periods are important to better characterize the efficacy and safety.