Short-Term Outcomes of Refractory Diabetic Macular Edema Switch From Ranibizumab to Dexamethasone Implant and the Influential Factors: A Retrospective Real World Experience
Introduction: To evaluate the effectiveness and safety of intravitreal dexamethasone (DEX) implants in refractory diabetic macular edema (DME) treated by intravitreal ranibizumab.Materials and Methods: We retrospectively analyzed DME patients who received DEX implant treatment after being refractory...
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Frontiers Media S.A.
2021-04-01
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| Series: | Frontiers in Medicine |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fmed.2021.649979/full |
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| author | Ning-Yi Hsia Chun-Ju Lin Chun-Ju Lin Chun-Ju Lin Huan-Sheng Chen Cheng-Hsien Chang Cheng-Hsien Chang Cheng-Hsien Chang Henry Bair Henry Bair Chun-Ting Lai Jane-Ming Lin Jane-Ming Lin Wen-Lu Chen Wen-Lu Chen Peng-Tai Tien Peng-Tai Tien Wen-Chuan Wu Yi-Yu Tsai Yi-Yu Tsai Yi-Yu Tsai |
| author_facet | Ning-Yi Hsia Chun-Ju Lin Chun-Ju Lin Chun-Ju Lin Huan-Sheng Chen Cheng-Hsien Chang Cheng-Hsien Chang Cheng-Hsien Chang Henry Bair Henry Bair Chun-Ting Lai Jane-Ming Lin Jane-Ming Lin Wen-Lu Chen Wen-Lu Chen Peng-Tai Tien Peng-Tai Tien Wen-Chuan Wu Yi-Yu Tsai Yi-Yu Tsai Yi-Yu Tsai |
| author_sort | Ning-Yi Hsia |
| collection | DOAJ |
| description | Introduction: To evaluate the effectiveness and safety of intravitreal dexamethasone (DEX) implants in refractory diabetic macular edema (DME) treated by intravitreal ranibizumab.Materials and Methods: We retrospectively analyzed DME patients who received DEX implant treatment after being refractory to at least 3 monthly intravitreal ranibizumab injections. The main outcomes were best-corrected visual acuity (BCVA), central retinal thickness (CRT), and intraocular pressure (IOP).Results: Twenty-nine eyes of 26 patients who had previously received an average of 8.1 ± 4.4 ranibizumab injections were included. Patients received between one and three DEX implants during 12.4 ± 7.4 months of follow-up. The mean final CRT significantly decreased from 384.4 ± 114.4 μm at baseline to 323.9 ± 77.7 μm (p = 0.0249). The mean final BCVA was 51.4 ± 21.3 letters, which was not significant compared to baseline (44.9 ± 30.2 letters, p = 0.1149). Mean IOP did not increase significantly. All patients tolerated the treatment well without serious adverse events. Higher baseline CRT and worse BCVA correlated with better therapeutic responses.Conclusion: Switching to DEX implant is feasible and safe for treating patients of DME refractory to intravitreal ranibizumab in real world. Further larger-scale or multicenter studies would be conducted to explore different DEX treatment strategies for DME, such as first-line or early switch therapy, for better BCVA improvement. |
| first_indexed | 2024-12-17T21:11:10Z |
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| issn | 2296-858X |
| language | English |
| last_indexed | 2024-12-17T21:11:10Z |
| publishDate | 2021-04-01 |
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| spelling | doaj.art-a0756916ea684d74b8e4713eccd97bd92022-12-21T21:32:28ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2021-04-01810.3389/fmed.2021.649979649979Short-Term Outcomes of Refractory Diabetic Macular Edema Switch From Ranibizumab to Dexamethasone Implant and the Influential Factors: A Retrospective Real World ExperienceNing-Yi Hsia0Chun-Ju Lin1Chun-Ju Lin2Chun-Ju Lin3Huan-Sheng Chen4Cheng-Hsien Chang5Cheng-Hsien Chang6Cheng-Hsien Chang7Henry Bair8Henry Bair9Chun-Ting Lai10Jane-Ming Lin11Jane-Ming Lin12Wen-Lu Chen13Wen-Lu Chen14Peng-Tai Tien15Peng-Tai Tien16Wen-Chuan Wu17Yi-Yu Tsai18Yi-Yu Tsai19Yi-Yu Tsai20Department of Ophthalmology, Eye Center, China Medical University Hospital, Taichung, TaiwanDepartment of Ophthalmology, Eye Center, China Medical University Hospital, Taichung, TaiwanSchool of Medicine, College of Medicine, China Medical University, Taichung, TaiwanDepartment of Optometry, Asia University, Taichung, TaiwanAn-Shin Dialysis Center, NephroCare Ltd., Fresenius Medical Care, Taichung, TaiwanDepartment of Ophthalmology, Eye Center, China Medical University Hospital, Taichung, TaiwanSchool of Medicine, College of Medicine, China Medical University, Taichung, TaiwanDepartment of Optometry, Asia University, Taichung, TaiwanDepartment of Ophthalmology, Eye Center, China Medical University Hospital, Taichung, TaiwanSchool of Medicine, Stanford University, Stanford, CA, United StatesDepartment of Ophthalmology, Eye Center, China Medical University Hospital, Taichung, TaiwanDepartment of Ophthalmology, Eye Center, China Medical University Hospital, Taichung, TaiwanDepartment of Optometry, Asia University, Taichung, TaiwanDepartment of Ophthalmology, Eye Center, China Medical University Hospital, Taichung, TaiwanDepartment of Optometry, Asia University, Taichung, TaiwanDepartment of Ophthalmology, Eye Center, China Medical University Hospital, Taichung, TaiwanGraduate Institute of Clinical Medical Science, China Medical University, Taichung, TaiwanDepartment of Ophthalmology, Eye Center, China Medical University Hospital, Taichung, TaiwanDepartment of Ophthalmology, Eye Center, China Medical University Hospital, Taichung, TaiwanSchool of Medicine, College of Medicine, China Medical University, Taichung, TaiwanDepartment of Optometry, Asia University, Taichung, TaiwanIntroduction: To evaluate the effectiveness and safety of intravitreal dexamethasone (DEX) implants in refractory diabetic macular edema (DME) treated by intravitreal ranibizumab.Materials and Methods: We retrospectively analyzed DME patients who received DEX implant treatment after being refractory to at least 3 monthly intravitreal ranibizumab injections. The main outcomes were best-corrected visual acuity (BCVA), central retinal thickness (CRT), and intraocular pressure (IOP).Results: Twenty-nine eyes of 26 patients who had previously received an average of 8.1 ± 4.4 ranibizumab injections were included. Patients received between one and three DEX implants during 12.4 ± 7.4 months of follow-up. The mean final CRT significantly decreased from 384.4 ± 114.4 μm at baseline to 323.9 ± 77.7 μm (p = 0.0249). The mean final BCVA was 51.4 ± 21.3 letters, which was not significant compared to baseline (44.9 ± 30.2 letters, p = 0.1149). Mean IOP did not increase significantly. All patients tolerated the treatment well without serious adverse events. Higher baseline CRT and worse BCVA correlated with better therapeutic responses.Conclusion: Switching to DEX implant is feasible and safe for treating patients of DME refractory to intravitreal ranibizumab in real world. Further larger-scale or multicenter studies would be conducted to explore different DEX treatment strategies for DME, such as first-line or early switch therapy, for better BCVA improvement.https://www.frontiersin.org/articles/10.3389/fmed.2021.649979/fulldiabetic macular edemaintravitreal dexamethasone implantintravitreal ranibizumabozurdexrefractory diabetic macular edema |
| spellingShingle | Ning-Yi Hsia Chun-Ju Lin Chun-Ju Lin Chun-Ju Lin Huan-Sheng Chen Cheng-Hsien Chang Cheng-Hsien Chang Cheng-Hsien Chang Henry Bair Henry Bair Chun-Ting Lai Jane-Ming Lin Jane-Ming Lin Wen-Lu Chen Wen-Lu Chen Peng-Tai Tien Peng-Tai Tien Wen-Chuan Wu Yi-Yu Tsai Yi-Yu Tsai Yi-Yu Tsai Short-Term Outcomes of Refractory Diabetic Macular Edema Switch From Ranibizumab to Dexamethasone Implant and the Influential Factors: A Retrospective Real World Experience Frontiers in Medicine diabetic macular edema intravitreal dexamethasone implant intravitreal ranibizumab ozurdex refractory diabetic macular edema |
| title | Short-Term Outcomes of Refractory Diabetic Macular Edema Switch From Ranibizumab to Dexamethasone Implant and the Influential Factors: A Retrospective Real World Experience |
| title_full | Short-Term Outcomes of Refractory Diabetic Macular Edema Switch From Ranibizumab to Dexamethasone Implant and the Influential Factors: A Retrospective Real World Experience |
| title_fullStr | Short-Term Outcomes of Refractory Diabetic Macular Edema Switch From Ranibizumab to Dexamethasone Implant and the Influential Factors: A Retrospective Real World Experience |
| title_full_unstemmed | Short-Term Outcomes of Refractory Diabetic Macular Edema Switch From Ranibizumab to Dexamethasone Implant and the Influential Factors: A Retrospective Real World Experience |
| title_short | Short-Term Outcomes of Refractory Diabetic Macular Edema Switch From Ranibizumab to Dexamethasone Implant and the Influential Factors: A Retrospective Real World Experience |
| title_sort | short term outcomes of refractory diabetic macular edema switch from ranibizumab to dexamethasone implant and the influential factors a retrospective real world experience |
| topic | diabetic macular edema intravitreal dexamethasone implant intravitreal ranibizumab ozurdex refractory diabetic macular edema |
| url | https://www.frontiersin.org/articles/10.3389/fmed.2021.649979/full |
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