Dex implant improves Pseudophakic cystoid macular edema in diabetes patients without retinopathy

A recent study comparing the effects of intravitreal dexamethasone (DEX) implants on diabetic and non-diabetic patients without diabetic retinopathy (DR) suffering from refractory pseudophakic cystoid macular edema (PCME) found favourable outcomes. The findings were published in International Journal of Retina and Vitreous.

The study, which included 42 patient records, aimed to understand the impact of DEX implants over a 12-month period following prior treatments with topical nepafenac 0.1% and prednisolone 1%. The patients' best-corrected visual acuity (BCVA) and central foveal thickness (CFT) were the main parameters assessed, and linear regression analysis was employed for statistical evaluation.

Before DEX implantation, both diabetic and non-diabetic subjects showed improvements with topical treatment. However, the real breakthrough came after DEX implantation. Non-diabetic patients experienced a remarkable gain in BCVA and a substantial reduction in CFT, with a mean BCVA gain of -0.35 and a CFT reduction of -195.71 µm. Diabetic patients, similarly, saw significant improvements, with a BCVA gain of -0.55 and a CFT reduction of -260.81 µm. These improvements were statistically significant (p < 0.001), indicating the potential efficacy of DEX implants.

Interestingly, patients who responded well to the initial topical treatment showed even better visual outcomes after DEX implantation. This correlation suggests that identifying patients who respond favorably to topical treatments may lead to improved results with subsequent DEX implantation.

One of the most significant findings of this study was that diabetic patients without DR responded comparably to non-diabetic patients in terms of BCVA and CFT improvements. This suggests that selected diabetic patients may benefit from this treatment just as much as their non-diabetic counterparts when dealing with PCME.

While further research is needed to confirm these findings and to explore the long-term effects of DEX implants, this study offers hope to those suffering from PCME.

Source:

Rodrigues, M. V., Garcia, J. M. B., Pacheco, K. D., Borges, F. T., Isaac, D. L. C., & Avila, M. (2023). Pseudophakic macular edema in nondiabetic and diabetic patients without diabetic retinopathy treated with intravitreal dexamethasone implant. In International Journal of Retina and Vitreous (Vol. 9, Issue 1). Springer Science and Business Media LLC. https://doi.org/10.1186/s40942-023-00489-2