6533b823fe1ef96bd127e31c

RESEARCH PRODUCT

Clinical Decision-Making when Treating Diabetic Macular Edema Patients with Dexamethasone Intravitreal Implants.

Alfredo García-layanaFélix ArmadáRafael NavarroMarta S. FigueroaÁLvaro Fernández-vegaJuan Peralta DonateRufino SilvaJosé M. Ruiz-morenoE. CerveraLuis AriasMaximino AbraldesAlfredo AdánFrancisco Cabrera

subject

0301 basic medicinemedicine.medical_specialtyVisual acuitygenetic structuresClinical Decision-MakingVisual AcuityDexamethasoneMacular Edema03 medical and health sciences0302 clinical medicineInternal medicineDiabetes mellitusDexamethasone Intravitreal ImplantMedicineHumansMacular edemaGlucocorticoidsDexamethasoneDrug ImplantsDiabetic Retinopathybusiness.industryGeneral MedicineDiabetic retinopathymedicine.diseaseeye diseasesSensory SystemsPathophysiologyOphthalmology030104 developmental biologyIntravitreal Injections030221 ophthalmology & optometrymedicine.symptombusinessTomography Optical Coherencemedicine.drugMedical literature

description

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.

10.1159/000486800https://pubmed.ncbi.nlm.nih.gov/29969772