Eyeworld

71 EW RETINA December 2016 Contact information Kaymak: h.kaymak@augenchirurgie.clinic Fricke: a.fricke@augenchirurgie.clinic noted that the therapy can be con- sidered in vitrectomized eyes because the Ozurdex slow-release implants offer stable pharmacokinetics. Dexamethasone was studied in DME patients in two previous investigations as a first line treat- ment. Both of the studies 2,3 showed positive outcomes. In terms of expectations, Dr. Kaymak noted, "We were hoping to see that we would in fact be giving fewer injections over time with this procedure. We know that with anti-VEGF therapy, we need at least six to seven injections per year to treat DME. Using this implant, we expect to only have to inject a patient three times a year, which is much more comfortable. The visual acuity we achieved was the same as what we are used to from monthly anti-VEGF injections or dexameth- asone injections, but the positive effects on BCVA and macular thick- ness last much longer. The lower injection frequency compared to anti-VEGF therapy allows us to also consider this treatment for patients with anxiety related to intravitreal injections." Dr. Kaymak is wary of inject- ing dexamethasone in the eyes of his glaucoma patients because it is likely that some of them will be steroid responders who will classi- cally develop increased IOP from repeated steroid use. "Being a steroid implant, the constant steroid effect in the vitreous will cause a response in so-called 'steroid responders.' This can cause glaucoma issues. Eye doctors keep this in mind and need to weigh their options when treating DME patients who have glaucoma. Glaucoma patients would need eye drops to keep their IOP down. We could use dexamethasone safely in this investigation since patients with glaucoma were excluded. Steroid therapy is effective as it has anti-in- flammatory, anti-permeability, and angiostatic effects for the successful treatment of DME," he said. EW References 1. Mehta H, et al. Perspective on the role of Ozurdex (dexamethasone intravitreal implant) in the management of diabetic macular oede- ma. Ther Adv Chronic Dis. 2015;6:234–245. 2. Boyer DS, et al. Three-year, randomized sh- am-controlled trial of dexamethasone intravit- real implant in patients with diabetic macular edema. Ophthalmology. 2014;121:1904–14. 3. Gilles MC, et al. A randomized clinical trial of intravitreal bevacizumab versus intrav- itreal dexamethasone for diabetic macular edema: the BEVORDEX study. Ophthalmology. 2014;121:2473–81. Editors' note: Drs. Kaymak and Fricke have no financial interests related to their comments. 2017 ASCRS•ASOA Symposium & Congress www.eyeworld.org Save the Date! Saturday, May 6, 2017 7:00 AM – 9:30 AM Los Angeles Convention Center CME credit is not available for Corporate Mornings programs. Visit www.eyeworld.org/meetings for program updates Registration opens January 2017! Corp AM 2017_Dec ad-island-NEW.qxp_Layout 2 11/17/16 11:35 PM Page 1

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