Título / Title

TREATMENT OF DIABETIC MACULAR EDEMA WITH INTRAVITREAL INJECTION OF ANTI-VEGF AGENT ASSOCIATED OR NOT WITH DEXAMETHASONE 4 MG/ML SOLUTION, RANDOMIZED CLINICAL TRIAL

Introdução / Purpose

To evaluate the best-corrected visual acuity (BCVA) and central macular thickness (CMT) outcomes of combined intravitreal injection of dexamethasone aqueous solution (IVD) and aflibercept (IVA) in patients with diabetic macular edema (DME) and its effect on intraocular pressure (IOP).

Material e Método / Methods

In this prospective interventional study, 28 eyes of 14 patients with DME were randomly assigned into two groups: in the first group, one eye received three monthly injections of combined IVD and IVB, and in the second group, one eye received three monthly intravitreal injections of aflibercept alone (IVA). The primary outcome was the inter-group difference in central macular thickness (CMT) measured by spectral-domain optical coherence tomography (OCT) from baseline to three months after the first injection. The secondary outcomes were the inter-group difference in best-corrected visual acuity (BCVA) and intraocular pressure (IOP) from baseline to three months after the first injection.

Resultados / Results

Reduction in CMT was significantly greater in the IVA+IVD group than the IVA group from baseline to three months after the first injection, corroborating improvement in BCVA was statistically bigger in the IVA+IVD group at this period. The intergroup IOP difference was not clinically significant at any time during the study. No inflammation or endophthalmitis was noticed.

Discussão e Conclusões / Conclusion

The addition of IVD to the standard EMD treatment with IVA regimen can improve structural and functional outcomes in the short term. Adverse effects related to the use of corticosteroids such as endophthalmitis, IOP rise, or intraocular inflammation are at a low risk.

Palavras Chave

Intravitreal injections, macular edema, dexamethasone, visual acuity, intraocular pressure.

Area

SURGICAL RETINA

Institutions

Federal University of Pernambuco - Recife - Pernambuco - Brasil

Authors

VALESCA CASTRO NERI, RODRIGO PESSOA CAVALCANTI LIRA, ANDREA ANDRADE AZEVEDO DE VASCONCELOS, PEDRO HENRIQUE LASALVIA JORGE, VICTOR DA CUNHA LIMA ALMEIDA