Therapeutic effect of simultaneous intravitreal dexamethasone and aflibercept on diabetic macular edema

Acta Diabetologica - Tập 59 - Trang 501-508 - 2021
Tai-Chi Lin1,2, Yu-Chien Chung3,4,5, Tsui-Kang Hsu2,6,7,8, Hsin-Wei Huang9,10, Yi-Ming Huang1,2, Yi-Chang Chou11,12, Chen-Yu Chao13, Po-Chen Tseng14,15,16
1Department of Ophthalmology, Taipei Veterans General Hospital, Taipei, Taiwan, Republic of China
2Department of Ophthalmology, School of Medicine, National Yang Ming Chiao Tung University, Hsinchu, Taiwan, Republic of China
3Department of Ophthalmology, Fu Jen Catholic University Hospital, Fu Jen Catholic University, New Taipei City, Taiwan, Republic of China
4School of Medicine, Fu Jen Catholic University, New Taipei City, Taiwan, Republic of China
5Graduate Institute of Business Administration, Fu Jen Catholic University, New Taipei City, Taiwan, Republic of China
6Department of Ophthalmology, Cheng Hsin General Hospital, Taipei, Taiwan, Republic of China
7Institue of Public Health, National Taiwan University, Taipei, Taiwan, Republic of China
8Department of Life Science, Institute of Molecular Biology, Institute of Biomedical Science, National Chung Cheng University, Chiayi, Taipei, Taiwan, Republic of China
9Department of Ophthalmology, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan (Republic of China)
10Graduate institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan, Republic of China
11Department of Education and Research, Taipei City Hospital, Taipei, Taiwan, Republic of China
12Institute of Public Health, National Yang Ming Chiao Tung University, Hsinchu, Taiwan, Republic of China
13Department of Life Science, Fu Jen Catholic University, New Taipei City, Taiwan, Republic of China
14Department of Ophthalmology, Taipei City Hospital, Taipei, Taiwan, Republic of China
15Department of Special Education, University of Taipei, Taipei, Taiwan, Republic of China
16Department of Optometry, University of Kang-Ning, Taipei, Taiwan, Republic of China

Tóm tắt

To report the effect of simultaneous intravitreal dexamethasone (DEX) and aflibercept for the treatment of diabetic macular edema (DME). This retrospective analysis of an open-label, multicenter, consecutive case series included 102 eyes of 81 patients with DME. Patients were selected into two groups. The control group consisted of 50 eyes treated with aflibercept alone, and the combination group consisted of 52 eyes treated with simultaneous DEX implant and aflibercept injection. The primary endpoints were changes in best-corrected visual acuity (BCVA) and central retinal thickness (CRT) from baseline to month 6. The secondary endpoint was the interval of retreatment. Baseline BCVA increased and CRT decreased at 6 months in both groups. Pseudophakic eyes in the combination group exhibited significantly greater BCVA improvement compared with phakic eyes (p = 0.031). Fewer intravitreal treatments were required for eyes treated with combination therapy than for those treated with aflibercept alone (1.56 ± 0.54 vs. 4.04 ± 1.26, p < .0001), with a mean retreatment interval of 3.66 ± 0.69 months. Simultaneous intravitreal DEX and aflibercept achieved non-inferior improvement of visual and anatomic outcomes compared with aflibercept alone for DME, but exhibited a significantly longer treatment interval and superior visual outcome in pseudophakic eyes. This therapeutic approach is considered a valid strategy for treating DME in the era of COVID-19.

Tài liệu tham khảo

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