Efficacy of Intravitreal Dexamethasone Implant for Diabetic Macular Edema According to Previous Responses to Bevacizumab. |
Doyeon Kim, Dong Geun Park, Gahyung Ryu, Min Sagong |
Department of Ophthalmology, Yeungnam University College of Medicine, Daegu, Korea. msagong@ynu.ac.kr |
당뇨황반부종에서 베바시주맙 치료 반응도에 따른 덱사메타손 삽입물의 효과 비교 |
김도연 · 박동근 · 류가형 · 사공민 |
영남대학교 의과대학 안과학교실 |
Correspondence:
Min Sagong, Email: msagong@ynu.ac.kr |
Received: 16 August 2019 • Revised: 30 September 2019 • Accepted: 30 December 2019 |
Abstract |
PURPOSE To compare the efficacy of intravitreal dexamethasone implants according to previous response to bevacizumab treatment in patients with diabetic macular edema (DME). METHODS: Forty-nine eyes of 49 patients who received intravitreal dexamethasone implants for DME were reviewed retrospectively. Of these patients, 13 were treatment-naïve and 36 had previously received intravitreal injections of bevacizumab. Of the 36 previously treated patients, 24 comprised a refractory group showing no response to previous injections, and 12 comprised a responder group showing a response to previous treatments. The best-corrected visual acuity, central macular thickness (CMT), and retreatment percentages were assessed monthly for 6 months. RESULTS: After the intravitreal dexamethasone implants, visual acuity improved significantly over 6 months in the treatment-naïve group, while in the responder group, a significant improvement in visual acuity was seen at the 2-month follow-up. In the refractory group, there was no significant improvement in visual acuity during the follow-up period. The CMT showed a significant decrease in all three groups, and there was no significant difference in the CMT among the three groups at any time point. Five patients in the treatment-naive group (38.5%), 19 patients in the refractory group (79.2%), and nine patients in the responder group (75.0%) needed retreatment for recurrent macular edema, and there was a significant difference among the three groups in the rate of recurrence (p = 0.034). CONCLUSIONS: In DME patients, intravitreal dexamethasone implants were associated with a significant anatomical improvement irrespective of previous bevacizumab treatment response. However, the treatment-naïve and responder groups showed improvements in visual acuity, whereas the refractory group showed limited improvement. |
Key Words:
Bevacizumab;Dexamethasone;Diabetic macular edema;Intravitreal injection;Macular edema |
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