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Dexamethasone effective for treating diabetic macular edema
10 March 2010
MedWire News: Intravitreous treatment with dexamethasone is well tolerated and significantly improves visual acuity in patients with persistent diabetic macular edema (DME), report researchers.
“The main cause of mild to moderate vision loss in diabetic retinopathy is DME,” explain Julia Haller (Wills Eye Institute, Philadelphia, Pennsylvania, USA) and colleagues.
“In a 10-year period, approximately 14% of patients with Type 2 diabetes who are not taking insulin will develop DME,” they add.
Haller and team carried out a randomized controlled trial including 315 patients with persistent DME. The participants were randomly assigned to receive treatment with dexamethasone 700 µg (n=105) or 350 µg (n=105) to one eye, or observation (n=105).
The dexamethasone drug delivery system (DDS) was implanted into the vitreous cavity of the eye in question.
The team tested the best-corrected visual acuity (BCVA) of the patients at baseline, day 90, and day 180. At day 90, a BCVA improvement of 10 letters or more was seen in 33.3%, 21.1%, and 12.3% of the dexamethasone 700 µg, 350 µg, and observation groups, respectively. At day 180, improvements in the corresponding groups were 30%, 19%, and 23%.
The improvement in the dexamethasone 700 µg group was statistically significantly greater than that in the observation group at 90, but not 180 days.
The researchers also found that there were significantly greater improvements in fluorescein leakage and central retinal thickness in treated compared with observed eyes.
Dexamethasone was generally well tolerated and side effects did not differ significantly between the treated and observation groups.
“DME remains the leading cause of vision loss in diabetic retinopathy, and thus warrants continued investigation into more effective and safer treatment options,” write Haller et al in the Archives of Ophthalmology.
The results of this study “suggest that dexamethasone DDS may be a promising new treatment option for eyes with persistent DME and support the conducting of clinical trials focused specifically on this patient population,” they conclude.
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