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12.07.2020 | Original Article

Long-term follow-up of diabetic macular edema treated with dexamethasone implant: a real-life study

Zeitschrift:
Acta Diabetologica
Autoren:
Thibaud Mathis, Théo Lereuil, Amro Abukashabah, Nicolas Voirin, Aditya Sudhalkar, Alper Bilgic, Philippe Denis, Corinne Dot, Laurent Kodjikian
Wichtige Hinweise
Thibaud Mathis and Théo Lereuil have contributed equally to this work.
This article belongs to the topical collection Eye Complications of Diabetes, managed by Giuseppe Querques

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Abstract

Aims

To evaluate the efficacy and safety of intravitreal dexamethasone implant (DEX-implant) for diabetic macular edema (DME) in real-life practice with an extended follow-up for up to 5 year.

Methods

This multicentric retrospective study reviewed 227 eyes of 152 patients with DME treated by DEX-implant. Main outcome measures included changes in best corrected visual acuity (BCVA), central macular thickness (CMT), time to retreatment and incidence of adverse effects.

Results

The mean number of DEX-implant received by patients was 2.6 (± 2.2) with a mean (SD) follow-up of 20.1 (± 15.8) months, median [IQR] 15.8 [7.4–30.1]. The mean time of retreatment was 6.9 months. The mean maximal BCVA gain during follow-up was 12.3 (± 12.7) letters. A gain of ≥ 5, ≥ 10 and ≥ 15 letters from baseline BCVA was obtained for 71.8%, 48.9% and 34.8% of eyes, respectively. A total of 62.6% of eyes presented a significant anatomical response (decrease of CMT ≥ 20%), and DME was resolved (absence of cystoid macular spaces on OCT) in 37% of cases at the end of the follow-up. A transient increase in intraocular pressure ≥ 25 mmHg occurred in 14.1% of eyes, and cataract surgery was performed for 49.1% of the phakic eyes during the follow-up. Four eyes developed a proliferative diabetic retinopathy.

Conclusion

This large cohort study showed favorable long-term outcomes when using DEX-implant, which provides substantial long-term benefits in the treatment of DME in real life.

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