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Document Type

Original Article

Abstract

Background: In those who are of working age, diabetic retinopathy is a typical microvascular consequence of diabetes that can lead to diabetic macular edema (DME) as well as visual impairment. Within the vitreous in patients who do not react to treatment with an anti-VEGF medicine, a dexamethasone implant can play a useful function in boosting both visual acuity and the shape of the macula. Aim and objectives: To evaluate the efficacy of intravitreal dexamethasone injection (Ozurdex) in treating DME in patients who had not responded to previous types of anti-VEGF therapy. Subjects and the methods: This was a prospective clinical trial that involved intervention and was carried out at Electricity Hospital. The nature of the trial was interventional. All of the people who took part in this research had a best-corrected visual acuity (BCVA) that ranged from 6/12 to 1/60, and they all suffered from persistent clinically significant macular edema that affected the fovea in the center of their vision. 4 months or more after receiving one or more treatments with anti-VEGF therapy that provided effective systemic control. In this particular study, there were a total of 17 eyes and 16 patients, 15 of which were male and one of which was female. Result: The average age of the cases was 63.29± 6.55 years old. The duration of diabetes mellitus was found to be 20.59 years, with a standard deviation of 6.53 years. According to the FBS and PPBS, the systemic management of DM was satisfactory. The pre-operative mean central macular thickness was 505.4± 183.3 m, and after surgery it had decreased to 349.2± 137.3 m, 337.5±111.1 m, and 310.9± 71.12 m accordingly at months 1, 3, and 6. The preoperative mean BCVA was 0.17 with an interquartile range (IQR) among 0.1 and 0.25. This value increased significantly after one month to be 0.17 with an IQR between 0.17 and 0.33 (P = 0.02), continued increasing significantly after three months as compared to baseline with a median of 0.25 and an IQR among 0.17 and 0.33 (P = 0.004), and similarly at six months with a median of 0.25 and an IQR between 0.1 and 0. Conclusion: In the course of therapy of refractory DME, which refers to cases in which the individual has not responded well to earlier medications, the DEX implant is a helpful choice because it has a favorable effect on VA and the thickness of the retina in the short term. Unfavorable occurrences can be effectively managed. The goal of management and monitoring protocols is to tailor therapy in order to get the best possible clinical outcomes while also minimizing the amount of work involved in the process.

Keywords

Intravitreal dexamethasone; Diabetic macular edema

Subject Area

Ophthalmology

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