Background Diabetic macular oedema (DME) is the main cause of impairment of visual acuity in diabetic patients. The current standard treatment for patients with DME (focal/grid laser photocoagulation) does not usually improve impaired vision, and many patients continue to lose vision despite laser treatment. Intravitreal drug treatments are important new options for the treatment of diabetic retinopathy. Dexamethasone intravitreal (DI) implants are not approved for the treatment of DME, although traditionally corticosteroids such as triamcinolone have been used intravitreally to decrease the DME.
Purpose To evaluate the safety and tolerability of DI implants and to assess compliance with the protocol for the treatment of DME.
Material and methods Retrospective review of 34 patients with decreased visual acuity, due to refractory DME, who received a single injection of dexamethasone between January 2012 and July 2014.
Our protocol recommended ranibizumab as the drug of first choice for DME and that dexamethasone should be administered to non-responders to ranibizumab or high cardiovascular risk patients (patients with a history of stroke within the last 6 months).
Results 34 patients were included in the study; 5/34 patients started with DI directly while 29/34 patients started with ranibizumab. The reason for the change was therapeutic failure (18/29 patients) and cardiovascular risk (11/29 patients). We did not detect any adverse effects in patients treated. Average transition time was 4 months. 13/34 patients received a single dose, 21/13 patients received two or more doses. The repeat interval was less than 6 months in 12/34 patients (median 5.3 months), longer than 6 months in 22/34 patients.
Conclusion High level of compliance with the protocol. In most patients the recommended interval of 6 months between doses of dexamethasone remains.
There was a tendency to shorten the interval between insertions of DI implants.
References and/or Acknowledgements No conflict of interest.
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