Dexamethasone intravitreal implant (Ozurdex) in patients with diabetic macular edema: Real life safety and efficacy

Purpose. The goal of this study was to investigate the safety and efficacy of the intravitreal dexamethasone implant (DI) for patients with diabetic macular edema (DME) in real life. Methods. We conducted a monocentric retrospective analysis of the change in visual acuity and central macular thickness ([MT) after intravitreal injection of the DI at peak efficacy (2 months after injection) as well as the timing of reinjections and complications in patients with a loss of vision due to DME. Results. Forty eyes of 33 patients were included, with a mean follow-up of 12.6 months. Thirty percent of the eyes experienced an increase in best corrected visual acuity (BCVA)> 15 letters at peak efficacy (P < 0.05) after each ID injection. Treatment-naive patients had a sustained response after Ozurdex injection, with better visual acuity at 3 months (P=0.02) and 4 months (P= 0.04) than non -naive patients and better visual acuity at 6 months despite identical baseline visual acuity (P < 0.05). Anatomical efficacy was good, with approximately 60% of patients with CMT < 300 microns at peak efficacy after each injection of ID. Thirty percent of eyes demonstrated ocular hypertension (OHT) > 25 mmHg at peak efficacy, and 12.5% of eyes required cataract surgery during follow-up. Conclusion. The DI has good functional and anatomic efficacy in these patients, with a good safety profile. Treatment-naive patients with more recent DME had a more sustained increase in visual acuity after the injections and better visual recovery at 6 months. This encourages us to initiate DI therapy early if there is no response to anti -vascular endothelial growth factor (anti-VEGF) treatment. (C) 2020 Elsevier Masson SAS. All rights reserved.