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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

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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Data availability

Not applicable.

Code availability

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Acknowledgements

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

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Correspondence to Ming Zhang.

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Cite this article

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 (2021). https://doi.org/10.1007/s00417-021-05369-9

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Keywords

  • Dexamethasone
  • Anti-vascular endothelial growth factor (anti-VEGF)
  • Diabetic macular edema (DME)
  • Meta-analysis