Intravitreal dexamethasone implant one month before versus concomitant with cataract surgery in patients with diabetic macular oedema: the dexcat study

2020 ◽  
Author(s):  
Matteo Fallico ◽  
Teresio Avitabile ◽  
Niccolò Castellino ◽  
Antonio Longo ◽  
Andrea Russo ◽  
...  
Keyword(s):  
Cataract Surgery ◽  
Macular Oedema ◽  
Diabetic Macular Oedema ◽  
Dexamethasone Implant ◽  
Intravitreal Dexamethasone Implant ◽  
Intravitreal Dexamethasone

Recommendations for the management of diabetic macular oedema with intravitreal dexamethasone implant: A national Delphi consensus study

2021 ◽  
pp. 112067212110528
Author(s):  
Laurent Kodjikian ◽  
Stephanie Baillif ◽  
Aude Couturier ◽  
Catherine Creuzot-Garcher ◽  
Marie-Noelle Delyfer ◽  
...  
Keyword(s):  
Macular Oedema ◽  
Diabetic Macular Oedema ◽  
Daily Practice ◽  
Dexamethasone Implant ◽  
Consensus Approach ◽  
Delphi Consensus ◽  
First Line ◽  
Anti Vegf ◽  
Intravitreal Dexamethasone Implant ◽  
Intravitreal Dexamethasone

Purpose The intravitreal dexamethasone implant (DEX-I) is an alternative to anti-VEGF for the first-line treatment of diabetic macular oedema (DME). However, several questions remain regarding its routine use and its place in certain situations not always specified in current recommendations. A national consensus approach was, therefore, initiated by French retinal experts. Methods An iterative Delphi consensus approach was used. A steering committee (SC) of seven experts analysed data from the literature to formulate statements divided into five key areas of treatment. These statements were submitted to the independent and anonymous electronic vote of 87 French retina experts among whom 39 expressed their opinion and therefore constituted the voting panel. Results After two rounds of voting, 22 and 7 of 38 statements received a strong consensus and a good consensus, respectively. The consensus level was higher for statements regarding first-line indications and safety of DEX-I compared to those regarding efficacy assessment, reprocessing time or pathophysiological biomarkers. The panellists recommended the preferential use of DEX-I for patients with limited availability for multiple injections, those who needed to undergo cataract surgery or who had a recent cardiovascular history, and as a therapeutic alternative to anti-VEGF in patients with a history of vitrectomy, retinal serous detachment, hyper-reflective points or dry exudates in optical coherence tomography (OCT). However, some statements proposed by SC experts were not validated. Conclusion This study provides some key recommendations to clinicians treating diabetic macular oedema, which may be useful when using intravitreal dexamethasone implants in daily practice.

Safety of 6000 intravitreal dexamethasone implants

2019 ◽  
Vol 104 (1) ◽  
pp. 39-46 ◽  
Author(s):  
Bindu Rajesh ◽  
Javier Zarranz-Ventura ◽  
Adrian T Fung ◽  
Catharina Busch ◽  
Niroj Kumar Sahoo ◽  
...  
Keyword(s):  
Intraocular Pressure ◽  
Retinal Detachment ◽  
Macular Oedema ◽  
Real Life ◽  
Cystoid Macular Oedema ◽  
Dexamethasone Implant ◽  
Intravitreal Dexamethasone Implant ◽  
Intravitreal Dexamethasone ◽  
Phakic Eyes

PurposeTo evaluate the real-life safety profile of intravitreal dexamethasone implant injection for various retinal conditions.MethodsRetrospective multicenter analysis of intravitreal dexamethasone implant injections (700 µg) due to various retinal conditions including central retinal venous occlusion (1861 injections), diabetic macular oedema (3104 injections), post-surgical cystoid macular oedema (305 injections) and uveitis (381 injections). The eyes were evaluated mainly for the occurrence of adverse events such as glaucoma, cataract, retinal detachment and endophthalmitis along during the follow-up period.ResultsA total of 6015 injections in 2736 eyes of 1441 patients (mean age of 65.7±12.9 years) were in total analysed over an average period of 18 months (range 6 months to 102 months). A total of 576 eyes (32.5% of the phakic eyes) developed cataract requiring surgical intervention. However, visually insignificant cataract progression was observed in another 259 phakic eyes (14.6%) which did not require surgical removal. A total of 727 eyes (26.5%) experienced an intraocular pressure (IOP) rise of >25 mm Hg, with 155 eyes (5.67%) having a prior history of glaucoma and 572 eyes (20.9%) having new onset IOP rise. Overall, more than 90% of eyes with IOP rise were managed medically, and 0.5% eyes required filtering surgery. Endophthalmitis (0.07%), retinal detachment (0.03%) and vitreous haemorrhage (0.03%) were rare. There was no significant change in visual acuity (p=0.87) and central macular thickness (p=0.12) at the last follow-up.ConclusionThis is the largest real-life study assessing the safety of intravitreal dexamethasone implant injections in various retinal conditions. Cataract progression and intraocular pressure rise are the most common side effects, but are often rather easily manageable.

scholarly journals Combined Intravitreal Dexamethasone Implant and Cataract Surgery in Patients with Diabetic Retinopathy: Effect on Retinal Morphology and Function

2020 ◽  
Vol 37 (11) ◽  
pp. 4675-4684
Author(s):  
Angelo Maria Minnella ◽  
Martina Maceroni ◽  
Stefano Maria Picardi ◽  
Giorgio Placidi ◽  
Elisa De Siena ◽  
...  
Keyword(s):  
Diabetic Retinopathy ◽  
Cataract Surgery ◽  
Dexamethasone Implant ◽  
Intravitreal Dexamethasone Implant ◽  
Intravitreal Dexamethasone ◽  
And Function

scholarly journals Intravitreal dexamethasone implant as an alternative to systemic steroids as prophylaxis for uveitic cataract surgery: a randomized trial

Eye ◽  
2019 ◽  
Vol 34 (3) ◽  
pp. 491-498 ◽  
Author(s):  
Aditya Sudhalkar ◽  
Abhay Vasavada ◽  
Deepak Bhojwani ◽  
Viraj Vasavada ◽  
Shail Vasavada ◽  
...  
Keyword(s):  
Cataract Surgery ◽  
Randomized Trial ◽  
Dexamethasone Implant ◽  
Systemic Steroids ◽  
Intravitreal Dexamethasone Implant ◽  
Intravitreal Dexamethasone
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