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

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.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.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 μm, 330 ± 97 μm, 347 ± 104 μm, 405 ± 149 μm, 383 ± 129 μm, and 397 ± 144 μm, 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.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.