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Efficacy and safety of single-dose dexamethasone implantation for patients with persistent diabetic macular edema: a systematic review and meta-analysis

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Abstract

Purpose

This meta-analysis was conducted to evaluate the efficacy and safety of single-dose dexamethasone implantation for treating persistent DME (diabetic macular edema) refractory to anti-VEGF (anti-vascular endothelial growth factor) drugs over a period of 6 months.

Methods

All related clinical trials were reviewed by searching electronic databases of PubMed, Medline, Web of Science, Cochrane Library, and EMBASE. The primary outcome parameters were best-corrected visual acuity (BCVA) and central macular thickness (CMT). We performed this meta-analysis by using Stata15.0.

Results

Ten clinical trials involving 362 eyes from 328 patients were eligible in the final analysis. After single-dose dexamethasone implantation, there was a significant improvement in BCVA from baseline to 1, 3, and 6 months with an average increase of − 0.15 logMAR (p < 0.001), − 0.14 logMAR (p < 0.001), and − 0.07 logMAR (p = 0.004), respectively. Further, mean CMT decreased significantly with an average reduction of 249.18 μm (p < 0.001), 217.66 μm (p < 0.001), and 91.56 μm (p < 0.001) at months 1, 3, and 6, respectively.

Conclusions

Our results indicate that switching to a dexamethasone implant could achieve significant anatomical and functional improvement among patients with refractory DME. Clinicians should be aware of this treatment option in refractory DME.

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Acknowledgements

The authors sincerely thank Editage (www.editage.cn) for English language editing.

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Authors and Affiliations

  1. Department of Ophthalmology, West China Hospital, Sichuan University, No. 37, Guoxue Alley, Chengdu, 610041, China

    Qiongzhen Yuan, Yilin Liu, Hanyue Xu, Yunxia Gao, Ling Qin, Yueqin Gou, Mengying Tao & Ming Zhang

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Yuan, Q., Liu, Y., Xu, H. et al. Efficacy and safety of single-dose dexamethasone implantation for patients with persistent diabetic macular edema: a systematic review and meta-analysis. Graefes Arch Clin Exp Ophthalmol 260, 405–413 (2022). https://doi.org/10.1007/s00417-021-05369-9

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