Efficacy and safety of single-dose dexamethasone implantation for patients with persistent diabetic macular edema: a systematic review and meta-analysis.

Autor: Yuan Q; Department of Ophthalmology, West China Hospital, Sichuan University, No. 37, Guoxue Alley, Chengdu, 610041, China., Liu Y; Department of Ophthalmology, West China Hospital, Sichuan University, No. 37, Guoxue Alley, Chengdu, 610041, China., Xu H; Department of Ophthalmology, West China Hospital, Sichuan University, No. 37, Guoxue Alley, Chengdu, 610041, China., Gao Y; Department of Ophthalmology, West China Hospital, Sichuan University, No. 37, Guoxue Alley, Chengdu, 610041, China., Qin L; Department of Ophthalmology, West China Hospital, Sichuan University, No. 37, Guoxue Alley, Chengdu, 610041, China., Gou Y; Department of Ophthalmology, West China Hospital, Sichuan University, No. 37, Guoxue Alley, Chengdu, 610041, China., Tao M; Department of Ophthalmology, West China Hospital, Sichuan University, No. 37, Guoxue Alley, Chengdu, 610041, China., Zhang M; Department of Ophthalmology, West China Hospital, Sichuan University, No. 37, Guoxue Alley, Chengdu, 610041, China. zhangmingscu@163.com.
Jazyk: angličtina
Zdroj: Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie [Graefes Arch Clin Exp Ophthalmol] 2022 Feb; Vol. 260 (2), pp. 405-413. Date of Electronic Publication: 2021 Sep 22.
DOI: 10.1007/s00417-021-05369-9
Abstrakt: Purpose: This meta-analysis was conducted to evaluate the efficacy and safety of single-dose dexamethasone implantation for treating persistent DME (diabetic macular edema) refractory to anti-VEGF (anti-vascular endothelial growth factor) drugs over a period of 6 months.
Methods: All related clinical trials were reviewed by searching electronic databases of PubMed, Medline, Web of Science, Cochrane Library, and EMBASE. The primary outcome parameters were best-corrected visual acuity (BCVA) and central macular thickness (CMT). We performed this meta-analysis by using Stata15.0.
Results: Ten clinical trials involving 362 eyes from 328 patients were eligible in the final analysis. After single-dose dexamethasone implantation, there was a significant improvement in BCVA from baseline to 1, 3, and 6 months with an average increase of - 0.15 logMAR (p < 0.001), - 0.14 logMAR (p < 0.001), and - 0.07 logMAR (p = 0.004), respectively. Further, mean CMT decreased significantly with an average reduction of 249.18 μm (p < 0.001), 217.66 μm (p < 0.001), and 91.56 μm (p < 0.001) at months 1, 3, and 6, respectively.
Conclusions: Our results indicate that switching to a dexamethasone implant could achieve significant anatomical and functional improvement among patients with refractory DME. Clinicians should be aware of this treatment option in refractory DME.
(© 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)
Databáze: MEDLINE
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