Dexamethasone implant for diabetic macular edema in naive compared with refractory eyes: the international retina group real-life 24-month multicenter study. The IRGREL-DEX study

Matias Iglicki*, Catharina Busch, Dinah Zur, Mali Okada, Miriana Mariussi, Jay Kumar Chhablani, Zafer Cebeci, Samantha Fraser-Bell, Voraporn Chaikitmongkol, Aude Couturier, Ermete Giancipoli, Marco Lupidi, Patricio J. Rodríguez-Valdés, Matus Rehak, Adrian Tien Chin Fung, Michaella Goldstein, Anat Loewenstein

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

60 Citations (Scopus)

Abstract

Purpose: To investigate efficacy and safety of repeated dexamethasone (DEX) implants over 24 months, in diabetic macular edema (DME) eyes that were treatment naive compared with eyes refractory to anti-vascular endothelial growth factor treatment, in a real-life environment. Methods: This multicenter international retrospective study assessed best-corrected visual acuity and central subfield thickness (CST) of naive and refractory eyes to anti-vascular endothelial growth factor injections treated with dexamethasone implants. Safety data (intraocular pressure rise and cataract surgery) were recorded. Results: A total of 130 eyes from 125 patients were included. Baseline best-corrected visual acuity and CST were similar for naive (n = 71) and refractory eyes (n = 59). Both groups improved significantly in vision after 24 months (P < 0.001). However, naive eyes gained statistically significantly more vision than refractory eyes (+11.3 ± 10.0 vs. 7.3 ± 2.7 letters, P = 0.01) and were more likely to gain ≥10 letters (OR 3.31, 95% CI 1.19-9.24, P = 0.02). At 6, 12, and 24 months, CST was significantly decreased compared with baseline in both naive and refractory eyes; however, CST was higher in refractory eyes than in naive eyes (CST 279 ± 61 vs. 313 ± 125 m, P = 0.10). Conclusion: Over a follow-up of 24 months, vision improved in diabetic macular edema eyes after treatment with dexamethasone implants, both in eyes that were treatment naive and eyes refractory to anti-vascular endothelial growth factor treatment; however, improvement was greater in naive eyes.

Original languageEnglish
Pages (from-to)44-51
Number of pages8
JournalRetina
Volume39
Issue number1
DOIs
Publication statusPublished - 1 Jan 2019

Keywords

  • anatomical outcomes
  • dexamethasone implant
  • diabetic macular edema
  • naive eyes
  • refractory eyes
  • visual outcomes

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