Short-Term Outcomes of Refractory Diabetic Macular Edema Switch From Ranibizumab to Dexamethasone Implant and the Influential Factors: A Retrospective Real World Experience

Frontiers in Medicine

article

Ning-Yi Hsia¹  Wen-Chuan Wu¹  Yi-Yu Tsai²  Chun-Ju Lin¹  Huan-Sheng Chen⁴  Cheng-Hsien Chang¹  Henry Bair¹  Chun-Ting Lai¹  Jane-Ming Lin¹  Wen-Lu Chen¹  Peng-Tai Tien¹ 

[1] Department of Ophthalmology, Eye Center, China Medical University Hospital;School of Medicine, College of Medicine, China Medical University;Department of Optometry, Asia University;An-Shin Dialysis Center, NephroCare Ltd.;School of Medicine, Stanford University, United States;Graduate Institute of Clinical Medical Science, China Medical University

关键词: diabetic macular edema;    intravitreal dexamethasone implant;    intravitreal ranibizumab;    ozurdex;    refractory diabetic macular edema;   

DOI  :  10.3389/fmed.2021.649979

学科分类：社会科学、人文和艺术（综合）

来源: Frontiers

【 摘 要 】

Introduction: To evaluate the effectiveness and safety of intravitreal dexamethasone (DEX) implants in refractory diabetic macular edema (DME) treated by intravitreal ranibizumab. Materials and Methods: We retrospectively analyzed DME patients who received DEX implant treatment after being refractory to at least 3 monthly intravitreal ranibizumab injections. The main outcomes were best-corrected visual acuity (BCVA), central retinal thickness (CRT), and intraocular pressure (IOP). Results: Twenty-nine eyes of 26 patients who had previously received an average of 8.1 ± 4.4 ranibizumab injections were included. Patients received between one and three DEX implants during 12.4 ± 7.4 months of follow-up. The mean final CRT significantly decreased from 384.4 ± 114.4 μm at baseline to 323.9 ± 77.7 μm ( p = 0.0249). The mean final BCVA was 51.4 ± 21.3 letters, which was not significant compared to baseline (44.9 ± 30.2 letters, p = 0.1149). Mean IOP did not increase significantly. All patients tolerated the treatment well without serious adverse events. Higher baseline CRT and worse BCVA correlated with better therapeutic responses. Conclusion: Switching to DEX implant is feasible and safe for treating patients of DME refractory to intravitreal ranibizumab in real world. Further larger-scale or multicenter studies would be conducted to explore different DEX treatment strategies for DME, such as first-line or early switch therapy, for better BCVA improvement.

【 授权许可】

CC BY