Intravitreal Dexamethasone Implant for the Treatment of Patient with Resistant to Anti-VEGF Diabetic Macular Edema

Abstract

Purpose. To evaluate the effectiveness of intravitreal injection of biodegradable intravitreal implant containing dexamethasone (Ozurdex) in patients with resistant diabetic macular edema (DME).Material and methods. The study was conducted of 24 patients with diabetic macular edema resistant to therapy with angiogenesis inhibitors (3-5 intravitreal injections without a positive structural and functional result) on the background of compensated type 2 diabetes mellitus. A biodegradable intravitreal implant containing dexamethasone (Ozurdex) was injected once according to standard method at a dose of 0.7 mg. The follow-up period was 6 months.Results. According to optical coherence tomography of the macular area, within 6 months after intravitreal injection of Ozurdex implant, the retinal thickness in the fovea decreased on average from 558.4 ± 25.1 μm to 188.3 ± 18.4 μm, with partial restoration of the foveolar cavity. The maximum corrected visual acuity increased on average from 0,04±0,01 to 0,3±0,09, intraocular pressure did not exceed 18.0 mm Hg.Conclusion. If the anti-angiogenic therapy of DME is ineffective, the use of the biodegradable intravitreal implant containing dexamethasone (Ozurdex) is considered as an effective treatment method that provides a significant and stable (prolonged) improvement of the structural and functional parameters of the eye in 86,6% cases.

Keywords

• resistant diabetic macular edema
• dexamethasone intravitreal implant