2Prof. Dr., MD, Istanbul Aydın University Faculty of Medicine, İstanbul, Turkey
3Assistant Dr., University of Health Sciences, Fatih Sultan Mehmet Training and Research Hospital, Istanbul, Turkey
4Ophthalmologist, University of Health Sciences Beyoğlu Training and Research Hospital, Istanbul, Turkey DOI : 10.37845/ret.vit.2022.31.7 Purpose: To evaluate the anatomical and visual outcomes of switching to intravitreal dexamethasone implant (IVD) in patients with diabetic macula edema unresponsive to 3 monthly consecutive intravitreal bevacizumab (IVB).
Methods: This retrospective study included patients with diabetic macular edema (DME) who showed anatomically poor response to 3 consecutive IVB injections and were switched to IVD treatment in early period. In the study population best-corrected visual acuity (BCVA), and central retinal thickness (CRT) were recorded at baseline, and on months 3, 6, 9, and 12.
Results: Overall, 27 eyes of 24 patients were included in our study. The mean age was 61.5 ± 9.5 years. The mean BCVA at baseline was 0.70 ± 0.21 LogMAR while the mean BCVA after 3 consecutive IVB injections was 0.69 ± 0.19 LogMAR. (p:0.83). The mean BCVA was 0.52 ± 0.21 LogMAR, 0.39 ± 0.22 LogMAR and 0.45 ± 0.27 LogMAR at 6, 9 and 12 months, respectively. (p=0.013, p=0.002, p<0.001). A statistically significant difference was observed for the mean BCVA at 6, 9 and 12 months compared to the mean BCVA at baseline and 3 months. The CMT was 522 ± 142 ?m and decreased to 499 ± 152 ?m at 3 months without statistical significance (p=0.51). After switching IVD, The mean CMT was 285 ± 40 ?m, 278 ± 116 ?m and 328 ± 172 ?m at 6, 9 and 12 months, respectively (p<0.001, p<0.001, p<0.001).
Conclusions: Better visual and anatomical results can be obtained with an early switch to IVD treatment in poorly responding DME.
Keywords : Dexamethasone, Bevacizumab, Diabetic macula edema