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Macular edema resolution assessment with implantable dexamethasone in diabetic retinopathy (MERIT): a pilot study

Authors Chhablani J, Jhingan M, Goud A, Vupparaboina KK, Das T

Received 24 January 2018

Accepted for publication 15 March 2018

Published 4 July 2018 Volume 2018:12 Pages 1205—1211


Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 3

Editor who approved publication: Dr Scott Fraser

Jay Chhablani, Mahima Jhingan, Abhilash Goud, Kiran Kumar Vupparaboina, Taraprasad Das

Smt Kanuri Santhamma Retina Vitreous Centre, LV Prasad Eye Institute, Hyderabad, Telangana, India

Purpose: This study aimed to evaluate the effect of dexamethasone implantation on the hard exudates (HEX) in patients with diabetic macular edema (DME).
Study design: This was a nonrandomized open-label single-center prospective trial.
Methods: This study included 15 eyes of 11 subjects with DME. Key inclusion criteria were naïve eyes with DME with HEX within 3 mm of fovea with center-involving DME; central macular thickness (CMT) >250 µm at baseline; best-corrected visual acuity (BCVA) between 20/400 and 20/40. Key exclusion criteria were previous intraocular surgery and history of panretinal photocoagulation (PRP) in past 4 months. The primary outcome measure was change in total HEX area at the macula (in mm2) measured by semiautomated algorithm. Secondary outcome measures were change in visual acuity, low-contrast visual acuity (LCVA), retinal sensitivity (RS) on macular microperimetry, and CMT.
Results: The total HEX area reduced from 1.5 mm2 (±1.46 mm2) at baseline to 0.89 mm2 (±1.062 mm2) at the final visit (p=0.185). The CMT improved significantly (p=0.03) from 488.67 µm (±240.66 µm) to 326.93 µm (±135.84 µm) at the final visit. Mean BCVA remained stable (p=0.95) (50.93±16.65 at baseline and 50.6±18.95 at final visit). The mean LCVA and RS showed insignificant improvement (p=0.31 and p=0.28, respectively).
Conclusion: Our pilot study demonstrated an improving trend in reduction of total HEX area and other anatomical outcomes, with limited functional outcomes. Larger randomized studies with a larger sample size with a control group are warranted to establish management protocols for DME with significant subfoveal HEX.

Keywords: dexamethasone implant, Ozurdex, hard exudates, diabetic macular edema

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