1 Vision Eye Institute Footscray, Melbourne, Australia 2 Australian Eye Specialists, Melbourne, Australia 3 Discipline of Orthoptics, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Australia
The aim of this retrospective observational study was to evaluate the efficacy of dexamethasone implant in the treatment of recalcitrant diabetic macular oedema in a real-world clinical setting.
Data was imported from patients' Ocular Coherence Tomography scans and imported into ImageJ software for quantitative segmental analysis by a masked observer. ImageJ was used to measure the intraretinal fluid volume and total central macular thickness. At baseline demographic information, previous treatment, number of implants, visual acuity, central macular thickness and analysis of intraretinal fluid using ImageJ analysis software were collected. Stata statistical analysis software was used to analysis the data.
Thirty-four eyes of 29 patients were included for analysis. The mean duration of diabetes mellitus was 19.8 years. The mean number of dexamethasone implants was 2.5 with a mean interval of 3.6 months. The greatest improvement in vision was demonstrated at two months where the mean gain was 4.6 letters (p<0.001). There was a significant decrease in central macular thickness from baseline to 12 months or the final patient visit (336.6 μm at baseline to 294.82 μm at final visit, p<0.001). At baseline the mean intraretinal fluid level was 421.1 μm2 and a clinically significant decrease was found at 12 months or patients’ last visit (103.06 microns, p<0.05).
The treatment of refractory or recurrent macular oedema with dexamethasone implant showed a significant improvement in visual acuity, central macular thickness and intraretinal fluid. The drug had minimal side effects in our patients and showed the added benefit of fewer injections required for re-treatment.