Clinical Decision-Making when Treating Diabetic Macular Edema Patients with Dexamethasone Intravitreal Implants
García-Layana A (1), Figueroa MS (2), Arias L (3), Adán A (4), Cabrera F (5), Abraldes M (6), Fernández-Vega Á (7), Navarro R (8), Cervera E (9), Silva R (10,11,12), Armadá F (13), Donate J (14), Ruiz-Moreno JM (15,16).
(1) Clínica Universidad de Navarra, Pamplona, Spain.
(2) Hospital Universitario Ramón y Cajal, Vissum Corp., Madrid, Spain.
(3) Hospital de Bellvitge, Barcelona, Spain.
(4) Hospital Clínic de Barcelona, Barcelona, Spain.
(5) Complejo Hospitalario Universitario Insular Materno-lnfantil de Gran Canaria, Las Palmas de Gran Canaria, Spain.
(6) Complexo Hospitalario Universitario de Santiago de Compostela, Universidad de Santiago de Compostela, Instituto Oftalmológico Gómez-Ulla, Santiago de Compostela, Spain.
(7) Instituto Oftalmológico Fernández-Vega, Oviedo, Spain.
(8) Instituto de Microcirugía Ocular, Barcelona, Spain.
(9) Hospital General de Valencia, Universidad de Valencia, Valencia, Spain.
(10) Department of Ophthalmology, Centro Hospitalar e Universitario de Coimbra (CHUC), Coimbra, Portugal.
(11) Faculty of Medicine, University of Coimbra, Institute for Biomedical Imaging and Life Sciences (FMUC-IBILI), Coimbra, Portugal.
(12) Association for Innovation and Biomedical Research on Light and Image (AIBILI), Coimbra, Portugal.
(13) Hospital La Paz, Madrid, Spain.
(14) Hospital Clínico San Carlos, Madrid, Spain.
(15) Universidad de Castilla La Mancha, Albacete, Spain.
(16) Hospital Universitario Puerta de Hierro-Majadahonda, Vissum Corp., Madrid, Spain.
Date: Apr 4, 2018Ophthalmology [SP]
Diabetes mellitus (DM) is a metabolic disease frequently associated with comorbidities that include diabetic macular edema (DME).
The current medical approach to treating DME involves intravitreal injections with either anti-vascular endothelial growth factors or steroids. However, the burden associated with intravitreal injections and DM-derived complications is high, underlining the need to find optimal treatment regimens.
In this article we describe the considerations we apply when treating DME patients with dexamethasone intravitreal implants (Ozurdex®), particularly those that influence the clinical decision-making process during the follow-up period.
These considerations are based both on the available medical literature and on our clinical experience following the use of these implants in this type of patient, the goal being to optimize the number of injections and the clinical outcome of this therapy.
We also provide a general overview of the pathophysiology of DME, highlighting the inflammatory component as a rationale to use steroids in these patients.
CITATION Ophthalmologica. 2018 Apr 4. doi: 10.1159/000486800
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