RESEARCH ARTICLE
Combined Intravitreal Dexamethasone Implant And Micropulse Yellow Laser For Treatment Of Anti-VEGF Resistant Diabetic Macular Edema
Ahmed Hosni Abd Elhamid*
Article Information
Identifiers and Pagination:
Year: 2017Volume: 11
First Page: 164
Last Page: 172
Publisher ID: TOOPHTJ-11-164
DOI: 10.2174/1874364101711010164
Article History:
Received Date: 14/04/2017Revision Received Date: 16/05/2017
Acceptance Date: 07/06/2017
Electronic publication date: 21/07/2017
Collection year: 2017
open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: https://creativecommons.org/licenses/by/4.0/legalcode. This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Abstract
Purpose:
To report the efficacy and safety of combined intravitreal dexamethasone implant and micropulse laser for anti-VEGF resistant diabetic macular edema.
Patients and Methods:
Prospective, non-controlled study that was conducted for twenty eyes with center-involved diabetic macular edema not responding to anti-VEGF therapy. Ozurdex intravitreal implant was injected to all eyes with subsequent micropulse yellow laser one month after the injection. All eyes were followed up after one, three, four, six, nine and twelve months. The primary outcome measure is the change in best corrected visual acuity (BCVA) after one year and secondary outcome measures are central macular thickness (CMT) change and safety of both dexamethasone implant and micropulse laser. Reinjection was done for those eyes with recurrent edema.
Results:
The mean age was 58.8 ±7.94 years. The mean BCVA was 0.6± 0.14, 0.57 ±0.12, 0.51±0.15, 0.59±0.12, 0.6± 0.12 and 0.59±0.14 after one, three, four, six, nine and twelve months in comparison to 0.45± 0.14 as initial BCVA [SS,P<0.05]. The CMT was 302.5±30.01, 330.6±20.24, 357.6±32.15, 285.4±19.95, 292.9±25.07 and 285.2±14.99µm after one ,three, four ,six , nine and twelve months in comparison to initial CMT of 420.7 ±38.74µm [HS, P<0.01]. Cataract occurred in 6 eyes from 14 phakic eyes (42.8%). Transient ocular hypertension occurred in 4 eyes (20%). Reinjection was done for eight eyes (40%), two eyes (10%) needed third injection.
Conclusion:
Combined Intravitreal dexamethasone implant and micropulse laser is effective and safe treatment option for anti-VEGF resistant diabetic macular edema.
