Outcome of Single Dexamethasone Implant Injection in the Treatment of Persistent Diabetic Macular Edema After Anti-VEGF Treatment: Real-Life Data from a Tertiary Hospital in Jordan
Received 25 January 2021
Accepted for publication 4 March 2021
Published 25 March 2021 Volume 2021:15 Pages 1285—1291
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 2
Editor who approved publication: Dr Scott Fraser
Motasem Al-Latayfeh,1,2 Mohammad Abdel Rahman,2 Raed Shatnawi1,2
1Department of General and Special Surgery, School of Medicine, The Hashemite University, Zarqa, Jordan; 2Department of Ophthalmology, Prince Hamza Hospital, Amman, Jordan
Correspondence: Motasem Al-Latayfeh
The Hashemite University, P.O. Box 150495, Zarqa, 13115, Jordan
Email [email protected]
Purpose: To analyze the real-life clinical outcome of a single dexamethasone implant (DEX) injection in the treatment of persistent diabetic macular edema (DME) after anti-vascular endothelial growth factor (anti-VEGF) agents in a sample of the Jordanian population.
Methods: An observational case study design that involved a retrospective chart review analysis in a tertiary hospital in Amman, Jordan. Patients who showed persistent DME after receiving at least six doses of anti-VEGF agents for DME treatment were included.
Results: The study population consisted of 72 participants (29 females, 43 males) having an average age of 66 years. All patients had best-corrected visual acuity (BCVA) less than 0.7 (6/9) and SD-OCT documented center-involved DME. The study results showed that the average baseline BCVA improved from 0.205± 0.1 before DEX injection to 0.358± 0.1 at 3 months post-injection (p< 0.0001). The central mean thickness (CMT) showed significant improvement also (539.347± 132.402 to 379.041± 99.430, p< 0.0001). There was a mean of 3 mmHg increase in intraocular pressure at 3 months post-injection (p< 0.0001), however, only 4% of patients required medical treatment. Other inflammatory biomarkers in OCT, such as intraretinal hyper-reflective dots (HRD), showed significant improvement also (23.67± 16 to 14.83± 13, p< 0.0001). No other significant safety concerns were noticed.
Conclusion: A single DEX injection showed significant clinical and anatomical improvement in DME cases that are persistent after anti-VEGF treatment in our sample, with an excellent safety profile. In case of supply shortage of intravitreal injections, which occurs frequently at our center, a single DEX injection may be utilized as an effective DME therapy. Further research is mandated to identify clinical response in a larger sample and more frequent injections.
Keywords: diabetic macular edema, dexamethasone, anti-VEGF, Ozurdex, Jordan
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