Dexamethasone Intravitreal Implant (Ozurdex) in the Treatment of Macular Edema: A Retrospective Study

Abstract

\n Background: To evaluate the efficacy and safety of intravitreal dexamethasone implant (Ozurdex) in the management of macular edema (ME) of varied etiology, particularly in case of diabetic macular edema (DME).Methods: This was a single-center, retrospective, observational, cohort study based on the data retrieved from the medical records of the patients with ME who were administered with dexamethasone intravitreal implant during 2013 to 2018. At baseline, a complete ophthalmologic evaluation, including measurement of visual acuity (VA), central retinal thickness (CRT), and intraocular pressure (IOP) was performed for all patients in the clinic. Descriptive statistics were used to summarize patients’ demographic and disease related data. Data were analyzed using XLSTAT statistical software for descriptive analysis. Statistical significance was set at p<0.05.Results: A total 114 patients with ME were included in this study. Diabetes mellitus (DM) was found to be the main etiology (80%; 91 out of 114 patients) and systemic comorbidity (92 out of 114) and those patients were considered as diabetic macular edema (DME) patients. All 114 patients received dexamethasone intravitreal implant and then followed up for next six months. Furthermore, 20.2% (23/114) and 0.9% (1//114) patients received the second Ozurdex injection alone or in combination with anti-VEGF, respectively, during the follow-up period on PRN basis. The CRT significantly reduced from baseline (480 µm) to 320 µm (p=0.0001) during six-month period with maximum reduction occurring in first three months. The pre-treatment mean VA (0.92 LogMAR) also significantly improved to 0.75 LogMAR (p=0.01) following three months of treatment. Mean pre-injection IOP increased from 15 mmHg to 21 mmHg in patients receiving dexamethasone implant. However, with the use of anti-glaucoma medication, the IOP was reduced to the baseline value.Conclusions: Dexamethasone intravitreal implant can be considered as an effective and safe treatment modality for ME patients, particularly the DME patients.