Author: Karin Herscu
Co-authors: Aseel Hamoud, Fani Zacharaki, Stephen Morgan, Samer Awwad
Purpose The aim of this study is to report on the 6 months results on the efficacy and safety of Dexamethasone intravitreal implant in patients with diabetic macular oedema DMO treated in Ashford & St. Peter’s Hospitals NHS Foundation Trust. Further to this we also report on adjuvant treatment modalities used, and complications
Setting/Venue Ophthalmology department at Ashford & St. Peter’s Hospitals NHS Foundation Trust.
Methods We performed a retrospective observational review of clinical notes of 20 consecutive patients (25 eyes) diagnosed with DMO and treated from January 2020 to December 2021 at Ashford & St. Peter’s Hospitals NHS Foundation Trust. The eyes had DMO on optical coherent tomography OCT. Treatment with intravitreal inserts releasing 0.7 mg of Dexamethasone (ozurdex) was given. We collected data on demographics. We measured the change of vision over 3-6 months. we measured change in central macular thickness CMT over 3-6 months. In addition, we measured intraocular pressure IOP change over 3-6 months. we recorded adjuvant treatment given over 3-6 months. Complications and secondary effects from the injections were also recorded.
Results The mean age at baseline was 72 years (59-85). 60% of patients were males, 40% were females. The mean BCVA changed from 0.528 Log MAR to 0.436 Log Mar after 3-6 months, (P value was not significant). The CMT changed from 469 μm before treatment to 399μm after 3-6 months (p value=0.000202). in most of the patients the IOP fluctuated between 17-21 mm Hg, only two of them has to be treated with topical anti glaucoma medication to control IOP. Thirteen of the patients (52%) are naïve i.e., they didn’t have any type of injection before the Dexamethasone, twelve (48%) did have other intravitreal injections before their treatment. Five of them had their cataract extraction surgery at the time of their Dexamethasone injection.
Conclusions With the recent covid-19 pandemic it was difficult for us to check our patients as we used to do. The Dexamethasone intravitreal insertion has a relatively long duration of action that allows patients to have a smaller number of hospital visits with effective treatment of their visual symptoms, side effects were minimal. Our study showed that Dexamethasone sustained release implant is effective in treating diabetic macular oedema, it’s well tolerated by patients.
Further study is needed regarding the long-term safety and effectivity of Dexamethasone implant, but our data hopes to contribute to that debate.