Dexamethasone Implants in Patients with Naive or Refractory Diffuse Diabetic Macular Edema

Purpose: To assess the effect of dexamethasone (DEX) 0.7 mg (Ozurdex (TM)) on refractory and treatment-naive diffuse diabetic macular edema. Methods: A prospective study was conducted in 76 patients (40 refractory and 36 naive) with visual acuities (VA) of 15-72 ETDRS letters, central macular thickness (CMT) >300 mu m and intraocular pressure (IOP) <25 mm Hg. After the DEX implant (+/- photocoagulation), VA, CMT and total macular volume (TMV) were assessed monthly for 6 months. Results: At every visit, VA improved significantly from baseline (p < 0.001) in both groups, but values were significantly better in the naive group, while CMT and TMV decreased significantly (p < 0.001) and similarly in both groups. The naive group received more photocoagulations (p = 0.001). There were 7.9% transient IOP increases >10 mm Hg. Conclusions: Substantial improvements in VA and CMT were achieved in both groups, and a gain of 1 ETDRS line was observed in the treatment-naive group as compared to the refractory group, with a good safety profile in both. (C) 2015 S. Karger AG, Basel