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Place of intravitreal dexamethasone implant in the treatment armamentarium of diabetic macular edema

World Journal of diabetes 2021年第8期12卷 1220-1232页

作者： Omer karti.ali Osman Saatci Department of Ophthalmology İzmir Democracy Universityİzmir 35330Turkey Department of Ophthalmology Dokuz Eylul Universityİzmir 35330Turkey

diabetic macular edema(DME)is a very important and well-known cause of visual loss in ***-retina barrier disruption and consequent intraretinal fluid accumulation may lead to retinal thickening at the posterior pole namely *** though it is not clearly understood,current evidence suggests that chronic low-grade inflammation characterized with various cytokines has a major role in the occurrence of *** trials are continuously shaping our treatment approaches for the eyes with ***,vascular endothelial growth factor(VEGF)inhibitor and steroid administrations are the main alternatives in DME ***(DEX)implant(Ozurdex®;Allergan,inc.,irvine,CA,United States)was approved by the United States Food&Drug Administration in 2014 for DME *** implant is made up of a biodegradable solid copolymer that is broken down by releasing its active ingredient into the vitreous cavity over *** release feature of this sustained-release drug delivery system ensures its efficacy for up to 6 mo with an acceptable and manageable safety *** implant provides a favorable anatomical and functional outcome in DME as shown in several randomized-controlled studies but has a relatively higher ocular side-effect profile such as increased risk of cataract formation and raised intraocular pressure when compared to the gold standard anti-VEGF ***,DEX implant becomes the second-line treatment option demonstrating inadequate clinical response to anti-VEGF ***,it can be preferred as the first-line treatment in vitrectomized and pseudophakic *** in some selected conditions DEX implant is favored over anti-VEGF agents where the use of VEGF-inhibitors is either inappropriate or contraindicated such as the patients with a recent history of a major cardiovascular or cerebrovascular event,pregnancy and noncompliant to frequent *** mini-review briefly overviews the efficacy,safety profile and complications o

关键词： Dexamethasone implant diabetic macular edema diabetic retinopathy Drugdelivery system Glaucoma Pharmacotherapy

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