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Efficacy of single-dose dexamethasone implantation in patients with persistent diabetic macular edema

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Abstract

To investigate the efficacy of single-dose intravitreal dexamethasone implantation in the treatment of persistent diabetic macular edema (DME) unresponsive to 3 consecutive ranibizumab injections over a period of 6 months. Forty-one patients with a previous history of treatment for DME including at least three consecutive intravitreal ranibizumab injections were enrolled in this retrospective study. Main outcome measures were change in best-corrected visual acuity (BCVA), central macular thickness (CMT), and intraocular pressure from baseline to 6th month. At the baseline, the mean CMT was 572.4 ± 123.1 μm which improved to 264.2 ± 114.4, 317.7 ± 141.7, 410.6 ± 169.1, and 382.8 ± 181.5 μm at the 1st, 3rd, 5th, and 6th month, respectively (p < 0.05). The preoperative mean BCVA was 0.85 ± 0.54 logMAR units which improved to 0.76 ± 0.5 (p = 0.08), 0.69 ± 0.4 (p = 0.02), 0.74 ± 0.4 (p = 0.284), and 0.72 ± 0.3 (p = 0.489) logMAR units at the 1st, 3rd, 5th, and 6th months, respectively. Additional injections were required for 13 (31 %) eyes at 3rd month and 14 (34 %) eyes at 5th month due to recurrence of macular edema. Intravitreal dexamethasone implantation caused a significant improvement of BCVA and reduction of CMT in the patients with persistent DME that were unresponsive to 3 consecutive ranibizumab injections. However, retreatment before 6 months in the majority of the patients was needed despite the beneficial effects after the index procedure.

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Authors and Affiliations

  1. Department of Ophthalmology, Ankara Atatürk Education and Research Hospital, Yıldırım Beyazıt University, Ankara, Turkey

    Mücella Arıkan Yorgun, Yasin Toklu, Melek Mutlu & Betül Seher Uysal

  2. Department of Ophthalmology, Faculty of Medicine, Hacettepe University, Ankara, Turkey

    Hasan Basri Çakmak

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  1. Mücella Arıkan Yorgun
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  2. Yasin Toklu
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Correspondence to Mücella Arıkan Yorgun.

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Arıkan Yorgun, M., Toklu, Y., Mutlu, M. et al. Efficacy of single-dose dexamethasone implantation in patients with persistent diabetic macular edema. Int Ophthalmol 36, 531–539 (2016). https://doi.org/10.1007/s10792-015-0155-6

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  • DOI: https://doi.org/10.1007/s10792-015-0155-6

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