Dexamethasone implant in pseudophakic and nonglaucomatous subgroup of diabetic macular edema patients: a real life experience

Purpose: To evaluate the efficacy of intravitreal dexamethasone implant (IDI) for the treatment of persistent diabetic macular edema (DME) in a subgroup of pseudophakic and nonglaucomatous eyes over a 12-month follow-up period. Methods: This was a retrospective, interventional study. Patients with persistent DME who were pseudophakic and did not have a glaucoma or ocular hypertension history, or a family history of glaucoma, were included. After an initial IDI injection, reinjections were performed on an as-needed basis. Changes in best-corrected visual acuity (BCVA), central retinal thickness (CRT), intraocular pressure (IOP), and number of injections at month 12 were evaluated. Results: The study included 50 eyes of 43 patients. Mean BCVA at baseline and at months 1, 3, 6, 9, and 12 were 0.22 +/- 0.17, 0.31 +/- 0.21, 0.25 +/- 0.17, 0.25 +/- 0.17, and 0.29 +/- 0.19 Snellen equivalent, respectively (p < 0.05 for all). Mean CRT at baseline and at months 1, 3, 6, 9, and 12 were 606 +/- 202 mu m, 330 +/- 97 mu m, 347 +/- 104 mu m, 405 +/- 149 mu m, 383 +/- 129 mu m, and 397 +/- 144 mu m, respectively (p < 0.0001 for all). Seven of the 50 eyes (14 %) showed an increase in IOP of >= 10 mm Hg and only 2 of them (4%) needed chronic antiglaucoma medication. The mean number of injections at month 12 was 2.04 +/- 0.5. Conclusions: In pseudophakic and nonglaucomatous eyes with DME, IDI was found to be beneficial in regard to visual and anatomic success and seemed safe in this selected group of patients.