2Uz. Dr., Samsun Eğitim Araştırma Hastanesi, Endokrinoloji ve Metabolizma, Samsun - TÜRKİYE Purpose: To investigate the efficacy of single-dose intravitreal dexamethasone implantation in the treatment of persistent diabetic macular edema (DME) unresponsive to five consecutive ranibizumab injections over a period of 6 months.
Material and Methods: Ten patients with a previous history of treatment for DME including at least five montly consecutive intravitreal ranibizumab injections were enrolled in this retrospective study. Best-corrected visual acuity (BCVA), central macular thickness (CMT), and intraocular pressure (IOP) levels were evaluated from baseline to 6th month.
Results: Ten eyes of ten patients were included (4 men and 6 women, mean age 55.4 ± 3.7 years) into the study. After the end of the 6th month since the application of intravitreal dexamethasone, CMT and BCVA showed a significant improvement compared to baseline levels. At the baseline, the mean CMT was 423±67.3 ?m which improved to 250 ±28.3, 252 ± 31.1 and 261 ±22.2 ?m at the 1st, 3rd and 6th month, respectively (p<0.001). The preinjection mean BCVA was 0.13± 0.08 which improved to 0.36 ± 0.14 (p<0.001), 0.34 ± 0.15 (p<0.001), and 0.13±0.08 (p=0.001) at the 1st, 3rd and 6th month, respectively. At the end of the 1st month in 5 patients IOP levels were measured over 21 mmHg but only two patients required an antiglaucomatous treatment and IOP levels were controlled at the end of 6th month. Cataract formation was observed in one patient at the end of 6th month.
Conclusion: Intravitreal dexamethasone implantation caused a significant improvement of BCVA and reduction of CMT in the patients with persistent DME that were unresponsive to five consecutive ranibizumab injections.
Keywords : Corticosteroid, dexamethasone, diabetic macular edema