Currently medications injected intravitreally in previously vitrectomized eyes have a very short half-life due to enhanced clearance of the drug. The use of the Ozurdex (dexamethasone) implant may allow sustained levels of steroid delivery to patients with diabetic macular edema that have undergone prior vitrectomy. The sustained steroid levels may lead to improved central retinal thickness measurements and improved visual acuity.
A total of 15 patients will be enrolled into the study. This is a 3 year randomized controlled study with the primary endpoint at 1 year. Secondary safety and efficacy endpoints will be evaluated in year 2 and year 3. Patients will be randomly enrolled into 1 of 3 groups: Group 1: Dexamethasone administered up to every 3 months Group 2: Dexamethasone administered up to every 6 months Group 3: Sham Patients will be evaluated on a monthly basis with ETDRS visual acuity, intraocular pressure, fundus examination and OCT. Ozurdex (dexamethasone) or Sham Procedure will be performed on Day 0. All patients will be evaluated monthly thereafter. One month following initial injection/sham, patients will be evaluated for focal or grid laser treatment if the investigator feels the patient will benefit. Re-implantation of Ozurdex may occur at any time \> 3 months following last injection in group 1 and \> 6 months following last injection in group 2 if any of the following conditions are met: 1. Increase of \> 50 microns from the best previous CRT measurement 2. Recurrence of intraretinal cystic edema 3. Persistent intraretinal cystic edema At 13 months, patients in the sham group will be eligible for Ozurdex implantation if initial inclusion/exclusion criteria are met. These patients would follow re-implantation guidelines of group 2 (up to every 6 months).
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
QUADRUPLE
Enrollment
3
Ozurdex (dexamethasone) 0.7mg steroid implant
Lahey Medical Center, One Essex Center Drive
Peabody, Massachusetts, United States
Visual Acuity Gain
Measured visual acuity gain in number of letters improved as a result of treatment
Time frame: 13 months
Central Retinal Thickness Reduction
Central Retinal Thickness Reduction as measured by Heidelberg OCT
Time frame: 1 year
Comparison of Efficacy Between Group 1 and 2
Comparison of efficacy between group 1 and group 2
Time frame: 3 years
Visual Acuity Gain at Year 2 and 3
VA gain in ETDRS letters at years 2 and years 3
Time frame: 3 years
Time to Reimplantation of Ozurdex Implant
Time in months until new implant is needed
Time frame: 3 years
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