Efficacy of the Intravitreal Sustained-Release Dexamethasone Implant for Diabetic Macular Edema Refractory to Anti-Vascular Endothelial Growth Factor Therapy: Meta-Analysis and Clinical Implications.

Abstract

BACKGROUND AND OBJECTIVE:

To assess the effect on best-corrected visual acuity (BCVA) and efficacy of the intravitreal sustained-release 0.7 mg dexamethasone implant (Ozurdex; Allergan, Irvine, CA) in patients with recalcitrant diabetic macular edema (DME).

PATIENTS AND METHODS:

Meta-analysis utilizing the MOOSE framework and a random effects model. Studies included adults undergoing treatment with Ozurdex for DME. The methodologic quality of each study was assessed using the MINORS and the Cochrane Collaboration Risk of Bias for randomized studies.

RESULTS:

A total of 3,859 patients among 15 studies were included in the final analysis. The mean difference in BCVA was a gain of four lines or 20 Early Treatment of Diabetic Retinopathy Study letters with Ozurdex at a mean follow-up period of 6 months.

CONCLUSIONS:

Treatment with Ozurdex is associated with significant mean improvement in visual acuity. Clinicians should have a multimodality approach to treating DME and be aware of this treatment option in those who have a suboptimal response to anti-VEGF therapy. [Ophthalmic Surg Lasers Imaging Retina. 2017;48:160-166.].

• Authors: Zainab Khan, Robin K Kuriakose, Maryam Khan, Eric K Chin, David R P Almeida
• Journal: Ophthalmic surgery, lasers & imaging retina (Ophthalmic Surg Lasers Imaging Retina) Vol. 48 Issue 2 Pg. 160-166 (02 01 2017) ISSN: 2325-8179 [Electronic] United States
• PMID: 28195619 (Publication Type: Journal Article, Meta-Analysis, Review)
• Copyright: Copyright 2017, SLACK Incorporated.

Chemical References

• Delayed-Action Preparations
• Drug Implants
• Glucocorticoids
• Vascular Endothelial Growth Factor A
• Dexamethasone

Topics

• Delayed-Action Preparations
• Dexamethasone (administration & dosage)
• Diabetic Retinopathy (complications, drug therapy)
• Drug Implants
• Drug Resistance
• Glucocorticoids (administration & dosage)
• Humans
• Intravitreal Injections
• Macular Edema (drug therapy, etiology)
• Treatment Outcome
• Vascular Endothelial Growth Factor A (antagonists & inhibitors)