Efficacy of Intravitreal Dexamethasone Implant (Ozurdex®) in Naïve and Refractory Patients with Different Morphological Subtypes of Diabetic Macular Edema

• Published in: Medicina (Kaunas, Lithuania) Vol. 61; no. 3; p. 488
• Main Authors: Stavrakas, Panagiotis, Christou, Evita Evangelia, Nasikas, Vasileios, Koutsiouki, Chrysoula, Vakalis, Athanasios, Asteriadis, Solon, Panos, Georgios D., Tranos, Paris
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 12.03.2025; MDPI
• Subjects: Aged; Central nervous system depressants; Comparative analysis; Comparative studies; Dexamethasone; Dexamethasone - administration & dosage; Dexamethasone - pharmacology; Dexamethasone - therapeutic use; Diabetes; Diabetic retinopathy; Diabetic Retinopathy - drug therapy; Dropsy; Drug Implants - therapeutic use; Edema; Female; Humans; Intravitreal Injections - methods; macular edema; Macular Edema - drug therapy; Male; Medical research; Medicine, Experimental; Middle Aged; Morphology; ozurdex; Patients; Quality of life; Retrospective Studies; Software; Statistical analysis; Steroids; Tomography, Optical Coherence - methods; Transplants & implants; Treatment Outcome; Vascular endothelial growth factor; Visual acuity; Visual Acuity - drug effects; Greece; South Dakota; Tennessee; United States > US; dexamethasone; macular edema; diabetes; ozurdex
• ISSN: 1648-9144; 1010-660X; 1648-9144
• DOI: 10.3390/medicina61030488

Background and Objectives: To investigate anatomical and functional outcomes in different morphological subtypes of diabetic macular edema (DME) treated with an intravitreal dexamethasone implant (Ozurdex) over 6 months follow-up. Materials and Methods: A retrospective, comparative study on patients with DME who received an intravitreal dexamethasone implant. Best-corrected visual acuity (BCVA), central subfoveal thickness (CST) and maximum CST on optical coherence tomography (OCT) were measured. The recruits were divided into three groups based on the morphological patterns of DME: serous retinal detachment (SRD), cystic macular edema (CME) and diffuse retinal thickening (DRT). The presence or absence of previous treatment were considered as being previously treated with anti-VEGF (PT) vs. naïve eyes (TN). All subjects received a single injection of the dexamethasone implant. The primary outcomes included changes in BCVA, CST and CSTMax at 2-, 4- and 6-months of follow-up. Results: CST was significantly reduced following one dexamethasone injection in the whole cohort from a total mean value of 513.3 μm to 368.2 μm at 2 months, 447.2 μm at 4 months and 471.5 μm at 6 months. The change in CST was significantly greater in SRD as opposed to the DRT and CME group at all time points. Overall, BCVA improved from 0.82 at baseline to 0.75 and 0.76 LogMAR at 2 and 4 months, respectively, whilst showing an overall deterioration to 0.84 at 6 months. The CME group showed the best BCVA at 6 months. Concerning treatment status (TN vs. PT), there was no significant difference in CST at 2 and 4 months, while CST was reduced at 6 months for the PT group (p = 0.023). Similarly, BCVA was significantly better in the PT group at 6 months (p = 0.017). Conclusions: The dexamethasone implant was effective in reducing DME and providing short-term BCVA improvement. The presence of SRD was associated with more favorable anatomical results, while CME was associated with better visual acuity. Dexamethasone provided superior results in previously treated patients.