2Uz. Dr., Gaziemir Devlet Hastanesi, Göz Kliniği, İzmir, Türkiye
3Uz. Dr., İzmir Katip Çelebi Üniversitesi Atatürk Eğitim ve Araştırma Hastanesi, Göz Kliniği, İzmir, Türkiye Purpose: To evaluate the effi cacy of an intravitreal dexamethasone (DEX) implant versus intravitreal ranibizumab (RAN) for chronic diabetic macular edema (DME) in Type 2 Diabetic Patients.
Materials and Methods: In this retrospective, comparative, cohort study, 28 eyes of 22 patients were received DEX implant at every 24 weeks. Thirty-seven eyes of 30 patients were performed RAN injections on pro re nata (PRN), immediately after three loading doses. Main outcome measures included best-corrected visual acuity (BCVA) and central macular thickness (CMT), intraocular pressure (IOP) and incidence of side effects in both groups.
Results: The mean change of BCVA for 12 months was -0, 11 Log MAR in DEX group and -0, 55 Log MAR in RAN group. There was a statistically signifi cant difference in BCVA between the DEX group and RAN group at month 6 and month 12 (p =0.0001 and p=0.0001). Mean CMT was significantly decreased in both groups from the baseline to month 6 and month 12 (DEX: p=0.001 and p=0.0001, RAN: p=0.0001, p=0.0001). Mean changes of CMT for 6 months and 12 months were -80 ?m and -127 ?m with the DEX group, and -204 ?m and -227?m with the RAN group. Mean IOP increased remarkably in the DEX group compared to the RAN group. However, 7 eyes with IOP higher than 21 mmHg were well controlled with topical anti-glaucoma drugs in DEX group.
Conclusion: The study demonstrated that more preferable functional and anatomic outcome could be provided by RAN injection than DEX implant for 12 months. BCVA and CMT improved signifi cantly as soon as one month and up to 4 months in DEX implant treatment, but were not maintained as well as RAN treatment.
Keywords : Dexamethasone implant, diabetic macular edema, diabetic retinopathy, ranibizumab