Treatment of diabetic macular edema with intravitreal DEX Implant in Germany: Efficacy and safety in naive and pre-treated patients in clinical practice

摘要

Purpose To investigate the efficacy and safety of dexamethasone (DEX) implant in eyes with diabetic macular edema (DME) over 12-months. Methods In this retrospective study charts from a single center were analysed, including naive and pre-treated patients. Best corrected visual acuity (BCVA) and central retinal thickness (CRT) were evaluated at baseline, months 1-2, 3-4, 5-6 and 7-12. Results Data of 77 eyes were analysed (58.4 were pre-treated with anti-VEGF inhibitors). Mean baseline BCVA values for the whole sample, pre-treated and naive patients, were 60.94 (SD 13.74), 60.85 (SD 13.80) and 61.01 (SD 13.86) letters, respectively. In the whole sample BCVA changes against baseline were significant (p < 0.05) at months 1-2, 3-4 and 7-12. In the pre-treated group changes were statistically significant at months 1-2 and 7-12. No statistically significant differences were found in the naive group and between subgroups. In the whole group and the pre-treated group, CRT changes against baseline were significant (p < 0.05) at all time points, while in the naive group changes were only significant at time point months 3-4. No statistically significant differences were found between subgroups. IOP increases were moderate and successfully managed with topical medication. Conclusion After treatment with DEX implant, BCVA increased and CRT decreased significantly in the whole population at all time points. No significant differences were found between naive and pre-treated patients. Changes in BCVA and CRT in the naive group were not statistically significant. This was most likely attributable to the small sample size. The data underlines the importance of DEX implant as an efficacious and safe alternative to VEGF- inhibitors in real world practice.