Efficacy of Intravitreal Dexamethasone Implant (Ozurdex<sup>®</sup>) in Naïve and Refractory Patients with Different Morphological Subtypes of Diabetic Macular Edema

<i>Background and Objectives</i>: To investigate anatomical and functional outcomes in different morphological subtypes of diabetic macular edema (DME) treated with an intravitreal dexamethasone implant (Ozurdex) over 6 months follow-up. <i>Materials and Methods</i>: A retros...

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Main Authors: Panagiotis Stavrakas, Evita Evangelia Christou, Vasileios Nasikas, Chrysoula Koutsiouki, Athanasios Vakalis, Solon Asteriadis, Georgios D. Panos, Paris Tranos
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Language:English
Published: MDPI AG 2025-03-01
Series:Medicina
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Online Access:https://www.mdpi.com/1648-9144/61/3/488
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author Panagiotis Stavrakas
Evita Evangelia Christou
Vasileios Nasikas
Chrysoula Koutsiouki
Athanasios Vakalis
Solon Asteriadis
Georgios D. Panos
Paris Tranos
author_facet Panagiotis Stavrakas
Evita Evangelia Christou
Vasileios Nasikas
Chrysoula Koutsiouki
Athanasios Vakalis
Solon Asteriadis
Georgios D. Panos
Paris Tranos
author_sort Panagiotis Stavrakas
collection DOAJ
description <i>Background and Objectives</i>: To investigate anatomical and functional outcomes in different morphological subtypes of diabetic macular edema (DME) treated with an intravitreal dexamethasone implant (Ozurdex) over 6 months follow-up. <i>Materials and Methods</i>: A retrospective, comparative study on patients with DME who received an intravitreal dexamethasone implant. Best-corrected visual acuity (BCVA), central subfoveal thickness (CST) and maximum CST on optical coherence tomography (OCT) were measured. The recruits were divided into three groups based on the morphological patterns of DME: serous retinal detachment (SRD), cystic macular edema (CME) and diffuse retinal thickening (DRT). The presence or absence of previous treatment were considered as being previously treated with anti-VEGF (PT) vs. naïve eyes (TN). All subjects received a single injection of the dexamethasone implant. The primary outcomes included changes in BCVA, CST and CSTMax at 2-, 4- and 6-months of follow-up. <i>Results</i>: CST was significantly reduced following one dexamethasone injection in the whole cohort from a total mean value of 513.3 μm to 368.2 μm at 2 months, 447.2 μm at 4 months and 471.5 μm at 6 months. The change in CST was significantly greater in SRD as opposed to the DRT and CME group at all time points. Overall, BCVA improved from 0.82 at baseline to 0.75 and 0.76 LogMAR at 2 and 4 months, respectively, whilst showing an overall deterioration to 0.84 at 6 months. The CME group showed the best BCVA at 6 months. Concerning treatment status (TN vs. PT), there was no significant difference in CST at 2 and 4 months, while CST was reduced at 6 months for the PT group (<i>p</i> = 0.023). Similarly, BCVA was significantly better in the PT group at 6 months (<i>p</i> = 0.017). <i>Conclusions</i>: The dexamethasone implant was effective in reducing DME and providing short-term BCVA improvement. The presence of SRD was associated with more favorable anatomical results, while CME was associated with better visual acuity. Dexamethasone provided superior results in previously treated patients.
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spelling doaj-art-510275ed1e1b4df683bbcacbad1eb5cc2025-08-20T02:42:22ZengMDPI AGMedicina1010-660X1648-91442025-03-0161348810.3390/medicina61030488Efficacy of Intravitreal Dexamethasone Implant (Ozurdex<sup>®</sup>) in Naïve and Refractory Patients with Different Morphological Subtypes of Diabetic Macular EdemaPanagiotis Stavrakas0Evita Evangelia Christou1Vasileios Nasikas2Chrysoula Koutsiouki3Athanasios Vakalis4Solon Asteriadis5Georgios D. Panos6Paris Tranos7Department of Ophthalmology, School of Medicine, University of Patras, 26504 Patras, GreeceOphthalmica Eye Institute, 54622 Thessaloniki, GreeceOphthalmica Eye Institute, 54622 Thessaloniki, GreeceOphthalmica Eye Institute, 54622 Thessaloniki, GreeceOphthalmica Eye Institute, 54622 Thessaloniki, GreeceOphthalmica Eye Institute, 54622 Thessaloniki, GreeceFirst Department of Ophthalmology, AHEPA University Hospital, School of Medicine, Aristotle University of Thessaloniki, 54636 Thessaloniki, GreeceOphthalmica Eye Institute, 54622 Thessaloniki, Greece<i>Background and Objectives</i>: To investigate anatomical and functional outcomes in different morphological subtypes of diabetic macular edema (DME) treated with an intravitreal dexamethasone implant (Ozurdex) over 6 months follow-up. <i>Materials and Methods</i>: A retrospective, comparative study on patients with DME who received an intravitreal dexamethasone implant. Best-corrected visual acuity (BCVA), central subfoveal thickness (CST) and maximum CST on optical coherence tomography (OCT) were measured. The recruits were divided into three groups based on the morphological patterns of DME: serous retinal detachment (SRD), cystic macular edema (CME) and diffuse retinal thickening (DRT). The presence or absence of previous treatment were considered as being previously treated with anti-VEGF (PT) vs. naïve eyes (TN). All subjects received a single injection of the dexamethasone implant. The primary outcomes included changes in BCVA, CST and CSTMax at 2-, 4- and 6-months of follow-up. <i>Results</i>: CST was significantly reduced following one dexamethasone injection in the whole cohort from a total mean value of 513.3 μm to 368.2 μm at 2 months, 447.2 μm at 4 months and 471.5 μm at 6 months. The change in CST was significantly greater in SRD as opposed to the DRT and CME group at all time points. Overall, BCVA improved from 0.82 at baseline to 0.75 and 0.76 LogMAR at 2 and 4 months, respectively, whilst showing an overall deterioration to 0.84 at 6 months. The CME group showed the best BCVA at 6 months. Concerning treatment status (TN vs. PT), there was no significant difference in CST at 2 and 4 months, while CST was reduced at 6 months for the PT group (<i>p</i> = 0.023). Similarly, BCVA was significantly better in the PT group at 6 months (<i>p</i> = 0.017). <i>Conclusions</i>: The dexamethasone implant was effective in reducing DME and providing short-term BCVA improvement. The presence of SRD was associated with more favorable anatomical results, while CME was associated with better visual acuity. Dexamethasone provided superior results in previously treated patients.https://www.mdpi.com/1648-9144/61/3/488dexamethasoneozurdexmacular edemadiabetes
spellingShingle Panagiotis Stavrakas
Evita Evangelia Christou
Vasileios Nasikas
Chrysoula Koutsiouki
Athanasios Vakalis
Solon Asteriadis
Georgios D. Panos
Paris Tranos
Efficacy of Intravitreal Dexamethasone Implant (Ozurdex<sup>®</sup>) in Naïve and Refractory Patients with Different Morphological Subtypes of Diabetic Macular Edema
Medicina
dexamethasone
ozurdex
macular edema
diabetes
title Efficacy of Intravitreal Dexamethasone Implant (Ozurdex<sup>®</sup>) in Naïve and Refractory Patients with Different Morphological Subtypes of Diabetic Macular Edema
title_full Efficacy of Intravitreal Dexamethasone Implant (Ozurdex<sup>®</sup>) in Naïve and Refractory Patients with Different Morphological Subtypes of Diabetic Macular Edema
title_fullStr Efficacy of Intravitreal Dexamethasone Implant (Ozurdex<sup>®</sup>) in Naïve and Refractory Patients with Different Morphological Subtypes of Diabetic Macular Edema
title_full_unstemmed Efficacy of Intravitreal Dexamethasone Implant (Ozurdex<sup>®</sup>) in Naïve and Refractory Patients with Different Morphological Subtypes of Diabetic Macular Edema
title_short Efficacy of Intravitreal Dexamethasone Implant (Ozurdex<sup>®</sup>) in Naïve and Refractory Patients with Different Morphological Subtypes of Diabetic Macular Edema
title_sort efficacy of intravitreal dexamethasone implant ozurdex sup r sup in naive and refractory patients with different morphological subtypes of diabetic macular edema
topic dexamethasone
ozurdex
macular edema
diabetes
url https://www.mdpi.com/1648-9144/61/3/488
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