Background: To identify different response patterns to intravitreal dexamethasone implants (IDI) in naïve and previously treated (PT) diabetic macular edema (DME) eyes in a real-life setting.
Methods: 342 IDI injections (203 DME eyes) were included. Number of IDI injections, percentage (%) of eyes with 1, 2, 3 and ³ 4 injections, time to reinjections, visual acuity (VA), intraocular pressure (IOP) and central retinal thickness (CRT) were evaluated for naïve and PT DME eyes over 24 months.
Results: Mean number of injections was significantly lower in naïve vs PT DME eyes (1.40±0.9 vs 1.82±0.9, p<0.001). The percentage of eyes receiving 1 injection was significantly higher in naïve vs PT DME eyes (76.1 vs 47.7), (p<0.001). However, it was significantly lower for 2 (16.4 vs 29.4), or 3 injections (1.4 vs 17.6) (both p<0.001), with no differences in eyes receiving ³4 injections (5.9 vs 5.1 respectively, p=0.80). Mean time to reinjection was not significantly different between both groups for the second, third and fourth injection (9.6±4.0 vs 10.0±5.5, p=0.75, 13.2±4.0 vs 16.0±3.5, p=0.21 and 21.7±3.8 vs 19.7±5.8, p=0.55). VA scores were consistently better in naïve vs PT DME eyes at all studied timepoints, with no significant differences in CRT reduction or adverse effect rates.
Conclusion: Naïve DME eyes received lower number of IDI injections and showed better VA levels than PT DME eyes for 24 months in a real-world setting. This data supports the IDI use in early DME stages and provide further evidence of better IDI response when used as first-line therapy.

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Posted 23 Oct, 2020
On 01 Nov, 2020
Received 24 Oct, 2020
Invitations sent on 13 Oct, 2020
On 13 Oct, 2020
On 08 Oct, 2020
On 07 Oct, 2020
On 07 Oct, 2020
Received 04 Oct, 2020
On 04 Oct, 2020
Received 27 Sep, 2020
Received 19 Sep, 2020
On 16 Sep, 2020
On 14 Sep, 2020
Invitations sent on 07 Sep, 2020
On 07 Sep, 2020
On 01 Sep, 2020
On 31 Aug, 2020
On 31 Aug, 2020
On 31 Aug, 2020
Posted 23 Oct, 2020
On 01 Nov, 2020
Received 24 Oct, 2020
Invitations sent on 13 Oct, 2020
On 13 Oct, 2020
On 08 Oct, 2020
On 07 Oct, 2020
On 07 Oct, 2020
Received 04 Oct, 2020
On 04 Oct, 2020
Received 27 Sep, 2020
Received 19 Sep, 2020
On 16 Sep, 2020
On 14 Sep, 2020
Invitations sent on 07 Sep, 2020
On 07 Sep, 2020
On 01 Sep, 2020
On 31 Aug, 2020
On 31 Aug, 2020
On 31 Aug, 2020
Background: To identify different response patterns to intravitreal dexamethasone implants (IDI) in naïve and previously treated (PT) diabetic macular edema (DME) eyes in a real-life setting.
Methods: 342 IDI injections (203 DME eyes) were included. Number of IDI injections, percentage (%) of eyes with 1, 2, 3 and ³ 4 injections, time to reinjections, visual acuity (VA), intraocular pressure (IOP) and central retinal thickness (CRT) were evaluated for naïve and PT DME eyes over 24 months.
Results: Mean number of injections was significantly lower in naïve vs PT DME eyes (1.40±0.9 vs 1.82±0.9, p<0.001). The percentage of eyes receiving 1 injection was significantly higher in naïve vs PT DME eyes (76.1 vs 47.7), (p<0.001). However, it was significantly lower for 2 (16.4 vs 29.4), or 3 injections (1.4 vs 17.6) (both p<0.001), with no differences in eyes receiving ³4 injections (5.9 vs 5.1 respectively, p=0.80). Mean time to reinjection was not significantly different between both groups for the second, third and fourth injection (9.6±4.0 vs 10.0±5.5, p=0.75, 13.2±4.0 vs 16.0±3.5, p=0.21 and 21.7±3.8 vs 19.7±5.8, p=0.55). VA scores were consistently better in naïve vs PT DME eyes at all studied timepoints, with no significant differences in CRT reduction or adverse effect rates.
Conclusion: Naïve DME eyes received lower number of IDI injections and showed better VA levels than PT DME eyes for 24 months in a real-world setting. This data supports the IDI use in early DME stages and provide further evidence of better IDI response when used as first-line therapy.

Figure 1

Figure 2

Figure 3

Figure 4
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