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Erschienen in: International Ophthalmology 2/2016

02.08.2015 | Original Paper

Efficacy of Ozurdex implant in recalcitrant diabetic macular edema—a single-center experience

verfasst von: Pooja Bansal, Vishali Gupta, Amod Gupta, Mangat Ram Dogra, Jagat Ram

Erschienen in: International Ophthalmology | Ausgabe 2/2016

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Abstract

The purpose of this study is to report the efficacy of intravitreal Ozurdex implant in managing recalcitrant diabetic macular edema. Retrospective interventional non-randomized study of patients with recalcitrant diabetic macular edema who received intravitreal Ozurdex implant. Main outcome measures were change in the central macular thickness, visual acuity, and intraocular pressure. Sixty-seven eyes of 52 patients with recalcitrant diabetic macular edema with a mean duration of 45.4 ± 22.5 months (range 6–96 months) were studied. Mean central macular thickness decreased from 514.2 ± 177.8 µm at baseline to 394.3 ± 152.2 µm (p = 0.007), 301.8 ± 93.0 µm (p < 0.000), 316.4 ± 115.6 µm (p < 0.000), and 419.9 ± 186.3 µ (p = 0.03) at 1, 6, 12, and 24 weeks, respectively. Mean best corrected visual acuity changed from 0.82 ± 0.46 log MAR to 0. 69 ± 0.44 log MAR (p = 0.122), 0.61 ± 0.40 log MAR (p = 0.007), 0.65 ± 0.37 log MAR (p = 0.024), and 0.68 ± 0.49 log MAR (p = 0.091) at 1, 6, 12, and 24 weeks, respectively. Single injection of intravitreal Ozurdex implant led to progressive decrease in central macular thickness with maximum percentage decrease at 6 weeks (41.2 %) from the baseline which was maintained up to 12 weeks. Eight eyes showed transient rise in intraocular pressure at 2 months which was controlled by antiglaucoma medications.
Literatur
1.
Zurück zum Zitat Bhagat N, Grigorian RA, Tutela A, Zarbin MA (2009) Diabetic macular edema: pathogenesis and management. Surv Ophthalmol 54:1–32 Bhagat N, Grigorian RA, Tutela A, Zarbin MA (2009) Diabetic macular edema: pathogenesis and management. Surv Ophthalmol 54:1–32
2.
Zurück zum Zitat Early treatment diabetic retinopathy study research group: photocoagulation for diabetic macular edema: early treatment diabetic retinopathy study report no 1. Arch Ophthalmol 1985;103:1796–1806 Early treatment diabetic retinopathy study research group: photocoagulation for diabetic macular edema: early treatment diabetic retinopathy study report no 1. Arch Ophthalmol 1985;103:1796–1806
3.
Zurück zum Zitat Schatz H, Madeira D, McDonald HR, Johnson RN (1991) Progressive enlargement of laser scars following grid laser photocoagulation for diffuse diabetic macular edema. Arch Ophthalmol 109:1549–1551CrossRefPubMed Schatz H, Madeira D, McDonald HR, Johnson RN (1991) Progressive enlargement of laser scars following grid laser photocoagulation for diffuse diabetic macular edema. Arch Ophthalmol 109:1549–1551CrossRefPubMed
4.
Zurück zum Zitat Funatsu H, Noma H, Mimura T, Eguchi S, Hori S (2009) Association of vitreous Inflammatory factors with diabetic macular edema. Ophthalmology 116:73–79CrossRefPubMed Funatsu H, Noma H, Mimura T, Eguchi S, Hori S (2009) Association of vitreous Inflammatory factors with diabetic macular edema. Ophthalmology 116:73–79CrossRefPubMed
6.
Zurück zum Zitat Intravitreal steroids for macular edema: the past, the present, and the future. Surv Ophthalmol 2008;53:139–149 Intravitreal steroids for macular edema: the past, the present, and the future. Surv Ophthalmol 2008;53:139–149
7.
Zurück zum Zitat Gillies MC, Islam FM, Zhu M, Larsson J, Wong TY (2007) Efficacy and safety of multiple intravitreal triamcinolone injections for refractory diabetic macular edema. Br J Ophthalmol 91:1323–1326CrossRefPubMedPubMedCentral Gillies MC, Islam FM, Zhu M, Larsson J, Wong TY (2007) Efficacy and safety of multiple intravitreal triamcinolone injections for refractory diabetic macular edema. Br J Ophthalmol 91:1323–1326CrossRefPubMedPubMedCentral
8.
Zurück zum Zitat Jonas JB, Kreissig I, Sofker A, Degenring RF (2003) Intravitreal injection of triamcinolone for diffuse diabetic macular edema. Arch Ophthalmol 121:57–61CrossRefPubMed Jonas JB, Kreissig I, Sofker A, Degenring RF (2003) Intravitreal injection of triamcinolone for diffuse diabetic macular edema. Arch Ophthalmol 121:57–61CrossRefPubMed
9.
Zurück zum Zitat Sutter FKP, Simpson JM, Gillies MC (2004) Intravitreal triamcinolone for diabetic macular edema that persists after laser treatment: three-month efficacy and safety results of a prospective, randomized, double-masked, placebo-controlled clinical trial. Ophthalmology 111:2044–2049CrossRefPubMed Sutter FKP, Simpson JM, Gillies MC (2004) Intravitreal triamcinolone for diabetic macular edema that persists after laser treatment: three-month efficacy and safety results of a prospective, randomized, double-masked, placebo-controlled clinical trial. Ophthalmology 111:2044–2049CrossRefPubMed
10.
Zurück zum Zitat Gillies MC, Sutter FK, Simpson JM, Larsson J, Ali H, Zhu M (2006) Intravitreal triamcinolone for refractory diabetic macular edema: two-year results of a doublemasked, placebo-controlled, randomized clinical trial. Ophthalmology 113:1533–1538CrossRefPubMed Gillies MC, Sutter FK, Simpson JM, Larsson J, Ali H, Zhu M (2006) Intravitreal triamcinolone for refractory diabetic macular edema: two-year results of a doublemasked, placebo-controlled, randomized clinical trial. Ophthalmology 113:1533–1538CrossRefPubMed
11.
Zurück zum Zitat Martidis A, Duker JS, Greenberg PB, Rogers AH, Puliafito CA, Reichel E (2002) Intravitreal triamcinolone for refractory diabetic macular edema. Ophthalmology 109:920–927CrossRefPubMed Martidis A, Duker JS, Greenberg PB, Rogers AH, Puliafito CA, Reichel E (2002) Intravitreal triamcinolone for refractory diabetic macular edema. Ophthalmology 109:920–927CrossRefPubMed
12.
Zurück zum Zitat Aiello LP, Beck RW, Bressler NM, Browning DJ, Chalam KV, Davis M et al (2011) Rationale for the diabetic retinopathy for the diabetic retinopathy clinical research network treatment protocol for center-involved diabetic macular edema. Diabetic Retinopathy Clinical Research Network; Writing Committee. Ophthalmology 118:5–14CrossRef Aiello LP, Beck RW, Bressler NM, Browning DJ, Chalam KV, Davis M et al (2011) Rationale for the diabetic retinopathy for the diabetic retinopathy clinical research network treatment protocol for center-involved diabetic macular edema. Diabetic Retinopathy Clinical Research Network; Writing Committee. Ophthalmology 118:5–14CrossRef
13.
Zurück zum Zitat Beck RW, Edwards AR, Aiello LP, Bressler NM, Ferris F, Glassman AR et al (2009) Diabetic retinopathy clinical research network (DRCR.net),: three-year follow-up of a randomized trial comparing focal/grid photocoagulation and intravitreal triamcinolone for diabetic macular edema. Arch Ophthalmol 127:245–251CrossRefPubMed Beck RW, Edwards AR, Aiello LP, Bressler NM, Ferris F, Glassman AR et al (2009) Diabetic retinopathy clinical research network (DRCR.net),: three-year follow-up of a randomized trial comparing focal/grid photocoagulation and intravitreal triamcinolone for diabetic macular edema. Arch Ophthalmol 127:245–251CrossRefPubMed
14.
Zurück zum Zitat Vanrell RH, Cardillo JA, Kuppermann BD (2011) Clinical applications of the sustained-release dexamethasone implant for treatment of macular edema. Clin Ophthalmol 5:139–146 Vanrell RH, Cardillo JA, Kuppermann BD (2011) Clinical applications of the sustained-release dexamethasone implant for treatment of macular edema. Clin Ophthalmol 5:139–146
15.
Zurück zum Zitat Kupperman BD, Blumenkranz MS, Haller JA et al (2007) Dexamethasone DDS Phase II Study Group. Randomized controlled study of an intravitreal dexamethasone drug delivery system in patients with persistent macular edema. Arch Ophthalmol 125:309–317CrossRef Kupperman BD, Blumenkranz MS, Haller JA et al (2007) Dexamethasone DDS Phase II Study Group. Randomized controlled study of an intravitreal dexamethasone drug delivery system in patients with persistent macular edema. Arch Ophthalmol 125:309–317CrossRef
16.
Zurück zum Zitat Haller JA, Dugel P, Weinberg DV, Chou C, Whitcup SM (2009) Evaluation of the safety and performance of an applicator for a novel intravitreal dexamethasone drug delivery system for the treatment of macular edema. Retina 29:46–51CrossRefPubMed Haller JA, Dugel P, Weinberg DV, Chou C, Whitcup SM (2009) Evaluation of the safety and performance of an applicator for a novel intravitreal dexamethasone drug delivery system for the treatment of macular edema. Retina 29:46–51CrossRefPubMed
17.
Zurück zum Zitat Haller JA, Kuppermann BD, Blumenkranz MS, Williams GA, Weinberg DV, Chou C et al (2010) Dexamethasone DDS Phase II Study Group: randomized controlled trial of an intravitreal dexamethasone drug delivery system in patients with diabetic macular edema. Arch Ophthalmol 128:289–296CrossRefPubMed Haller JA, Kuppermann BD, Blumenkranz MS, Williams GA, Weinberg DV, Chou C et al (2010) Dexamethasone DDS Phase II Study Group: randomized controlled trial of an intravitreal dexamethasone drug delivery system in patients with diabetic macular edema. Arch Ophthalmol 128:289–296CrossRefPubMed
18.
Zurück zum Zitat Boyer DS, Faber D, Gupta S, Patel SS, Tabandeh H, Li XY et al (2011) Ozurdex Champlain study group: dexamethasone intravitreal implant for treatment of diabetic macular edema in vitrectomized patients. Retina 5:915–923CrossRef Boyer DS, Faber D, Gupta S, Patel SS, Tabandeh H, Li XY et al (2011) Ozurdex Champlain study group: dexamethasone intravitreal implant for treatment of diabetic macular edema in vitrectomized patients. Retina 5:915–923CrossRef
19.
Zurück zum Zitat Zucchiatti I, Lattanzio R, Querques G, Turco C, Cascavilla M, Bandello F et al (2012) Intravitreal dexamethasone implant in patients with persistent diabetic macular edema. Ophthalmologica 228:117–122CrossRefPubMed Zucchiatti I, Lattanzio R, Querques G, Turco C, Cascavilla M, Bandello F et al (2012) Intravitreal dexamethasone implant in patients with persistent diabetic macular edema. Ophthalmologica 228:117–122CrossRefPubMed
20.
Zurück zum Zitat Rishi P, Rishi E, Kuniyal L, Mathur G (2012) Short-term results of intravitreal dexamethasone implant (OZURDEX®) in treatment of recalcitrant diabetic macular edema: a case series. Oman J Ophthalmol 5:79–82CrossRefPubMedPubMedCentral Rishi P, Rishi E, Kuniyal L, Mathur G (2012) Short-term results of intravitreal dexamethasone implant (OZURDEX®) in treatment of recalcitrant diabetic macular edema: a case series. Oman J Ophthalmol 5:79–82CrossRefPubMedPubMedCentral
21.
Zurück zum Zitat Callanan D, Gupta S, Boyer D, Ciulla T, Singer M, Kuppermann B et al (2013) Dexamethasone intravitreal implant in combination with laser photocoagulation for the treatment of diffuse diabetic macular edema. Ophthalmology 120:1843–1851CrossRefPubMed Callanan D, Gupta S, Boyer D, Ciulla T, Singer M, Kuppermann B et al (2013) Dexamethasone intravitreal implant in combination with laser photocoagulation for the treatment of diffuse diabetic macular edema. Ophthalmology 120:1843–1851CrossRefPubMed
22.
Zurück zum Zitat Staurenghi Giovanni, Sadda Srinivas, Chakravarthy Usha, Spaide Richard F (2014) Proposed lexicon for anatomic landmarks in normal posterior segment spectral- domain optical coherence tomography. Ophthalmology 121:1572–1578CrossRefPubMed Staurenghi Giovanni, Sadda Srinivas, Chakravarthy Usha, Spaide Richard F (2014) Proposed lexicon for anatomic landmarks in normal posterior segment spectral- domain optical coherence tomography. Ophthalmology 121:1572–1578CrossRefPubMed
23.
Zurück zum Zitat Sakamoto A, Hangai M, Yoshimura N (2008) Spectral domain optical coherence tomography with multiple B-scan averaging for enhanced imaging of retinal diseases. Ophthalmology 115:1071–1078CrossRefPubMed Sakamoto A, Hangai M, Yoshimura N (2008) Spectral domain optical coherence tomography with multiple B-scan averaging for enhanced imaging of retinal diseases. Ophthalmology 115:1071–1078CrossRefPubMed
24.
Zurück zum Zitat Puliafito CA, Hee MR, Lin CP, Rechiel E, Schuman JS, Duker JS et al (1995) Imaging of macular diseases with optical coherence tomography. Ophthalmology 102:217–229CrossRefPubMed Puliafito CA, Hee MR, Lin CP, Rechiel E, Schuman JS, Duker JS et al (1995) Imaging of macular diseases with optical coherence tomography. Ophthalmology 102:217–229CrossRefPubMed
25.
Zurück zum Zitat Otani T, Yamaguchi Y, Kishi S (2010) Correlation between visual acuity and foveal microstructural changes in diabetic macular edema. Retina 30:774–780CrossRefPubMed Otani T, Yamaguchi Y, Kishi S (2010) Correlation between visual acuity and foveal microstructural changes in diabetic macular edema. Retina 30:774–780CrossRefPubMed
26.
Zurück zum Zitat Shin HJ, Lee SH, Chung H, Kim HC (2012) Association between photoreceptor integrity and visual outcome in diabetic macular edema. Graefes Arch Clin Exp Ophthalmol 250:61–70CrossRefPubMed Shin HJ, Lee SH, Chung H, Kim HC (2012) Association between photoreceptor integrity and visual outcome in diabetic macular edema. Graefes Arch Clin Exp Ophthalmol 250:61–70CrossRefPubMed
27.
Zurück zum Zitat Coscas G, Coscas F, Zucchiatti I, Glacet-Bernard A, Soubrane G, Souied E (2011) SD-OCT pattern of retinal venous occlusion with cystoid macular edema treated with Ozurdex ®. Eur J Ophthalmol 21:631–636CrossRefPubMed Coscas G, Coscas F, Zucchiatti I, Glacet-Bernard A, Soubrane G, Souied E (2011) SD-OCT pattern of retinal venous occlusion with cystoid macular edema treated with Ozurdex ®. Eur J Ophthalmol 21:631–636CrossRefPubMed
28.
Zurück zum Zitat Shin HJ, Chung H, Kim HC (2011) Association between integrity of foveal photoreceptor layer and visual outcome in retinal vein occlusion. Acta Ophthalmol 89:35–40CrossRef Shin HJ, Chung H, Kim HC (2011) Association between integrity of foveal photoreceptor layer and visual outcome in retinal vein occlusion. Acta Ophthalmol 89:35–40CrossRef
29.
Zurück zum Zitat Ota M, Tsujikawa A, Murakami T, Yamaike N, Sakamoto A, Kotera Y et al (2008) Foveal photoreceptor in eyes with persistent cystoid macular edema associated with branch retinal vein occlusion. Am J Ophthalmol 145:273–280CrossRefPubMed Ota M, Tsujikawa A, Murakami T, Yamaike N, Sakamoto A, Kotera Y et al (2008) Foveal photoreceptor in eyes with persistent cystoid macular edema associated with branch retinal vein occlusion. Am J Ophthalmol 145:273–280CrossRefPubMed
30.
Zurück zum Zitat Ianetti L, Spinucci G, Abbouda A, De Geronimo D, Tortorella D, Accorinti M (2012) Spectral domain optical coherence tomography in uveitic macular edema: morphological features and prognostic factors. Ophthalmologica 228:13–18CrossRef Ianetti L, Spinucci G, Abbouda A, De Geronimo D, Tortorella D, Accorinti M (2012) Spectral domain optical coherence tomography in uveitic macular edema: morphological features and prognostic factors. Ophthalmologica 228:13–18CrossRef
31.
Zurück zum Zitat Guigou S, Hajjar C, Parrat E, Merite PY, Pommier S, Matonti F et al (2014) Multicenter Ozurdex® assessment for diabetic macular edema: MOZART study. J Fr Ophtalmol 37:480–485CrossRefPubMed Guigou S, Hajjar C, Parrat E, Merite PY, Pommier S, Matonti F et al (2014) Multicenter Ozurdex® assessment for diabetic macular edema: MOZART study. J Fr Ophtalmol 37:480–485CrossRefPubMed
32.
Zurück zum Zitat Boyer DS, Yoon YH, Belfort R Jr, Bandello F, Maturi RK, Augustin AJ et al (2014) Ozurdex MEAD study group. Three-year, randomized, sham-controlled trial of dexamethasone intravitreal implant in patients with diabetic macular edema. Ophthalmology 121:1904–1914CrossRefPubMed Boyer DS, Yoon YH, Belfort R Jr, Bandello F, Maturi RK, Augustin AJ et al (2014) Ozurdex MEAD study group. Three-year, randomized, sham-controlled trial of dexamethasone intravitreal implant in patients with diabetic macular edema. Ophthalmology 121:1904–1914CrossRefPubMed
33.
Zurück zum Zitat Gillies MC, Lim LL, Campain A, Quin GJ, Salem W, Li J et al (2014) A randomized clinical trial of intravitreal bevacizumab versus intravitreal dexamethasone for diabetic macular edema: the BEVORDEX study. Ophthalmology 121:2473–2481CrossRefPubMed Gillies MC, Lim LL, Campain A, Quin GJ, Salem W, Li J et al (2014) A randomized clinical trial of intravitreal bevacizumab versus intravitreal dexamethasone for diabetic macular edema: the BEVORDEX study. Ophthalmology 121:2473–2481CrossRefPubMed
Metadaten
Titel
Efficacy of Ozurdex implant in recalcitrant diabetic macular edema—a single-center experience
verfasst von
Pooja Bansal
Vishali Gupta
Amod Gupta
Mangat Ram Dogra
Jagat Ram
Publikationsdatum
02.08.2015
Verlag
Springer Netherlands
Erschienen in
International Ophthalmology / Ausgabe 2/2016
Print ISSN: 0165-5701
Elektronische ISSN: 1573-2630
DOI
https://doi.org/10.1007/s10792-015-0103-5

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