The purpose of the investigator's study is to evaluate the efficacy and safety profile of the pro re nata (PRN) regimen to 12 months by using intravitreal dexamethasone implant in eyes with treatment-naive diabetic macular edema patients.
Pathogenesis of diabetic macular edema (DME) involves inflammation, angiogenesis, and oxidative stress processes provoked mainly by cytokines such as interleukin (IL)-6, 8, and monocyte chemotactic protein, and vascular endothelial growth factor (VEGF). Vision loss associated with diabetic retinopathy is most commonly caused by DME, which affects approximately 7% of all diabetic patients. Several therapeutic options are available for treating DME. Evidence for the use of these therapies is accumulating; however, the optical treatment choice remains unclear. In recent years, using intravitreal anti-VEGF agents to treat DME has been shown to be beneficial. Anti-VEGF injections are generally considered suitable first-line therapy for center-involved DME and are effective in improving visual acuity (VA), with 10% to 40% of patients achieving significant improvement in best-corrected visual acuity (BCVA) after 1 year of treatment. The management of DME is complex, and often multiple treatment approaches are needed. Although anti-VEGF agents were effective for the treatment of DME, there is a proportion of patients who do not achieve optimal response to these agents, presenting refractory or persistent DME. Intravitreal administration of steroids for the treatment of DME has also been studied for many years due to their well-known, widespread, anti-inflammatory effects. Dexamethasone implant is a slow-release dexamethasone delivery system developed for intravitreal administration that has recently been introduced as a therapeutic option in DME.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
49
Dexamethasone 0.7mg is injected into the vitreous cavity through the pars plana using applicator for diabetic macular edema.
Dong-A University Hospital
Busan, South Korea
RECRUITINGMaryknoll Medical Center
Busan, South Korea
RECRUITINGGyeongsang National University Changwon Hospital
Changwon, South Korea
Mean change of best corrected visual acuity
The mean change of best corrected visual acuity from baseline to Month 6 in early treatment diabetic retinopathy (ETDRS) letter score by using Logarithm of the Minimum Angle of Resolution (LogMAR) chart
Time frame: From baseline to month 6
Mean change of best corrected visual acuity
The change in mean best corrected visual acuity at baseline as measured by the early treatment diabetic retinopathy letter score by using Logarithm of the Minimum Angle of Resolution (LogMAR) chart
Time frame: From baseline to month 12
Mean change in central macular thickness
The mean change in central macular thickness (um) by using optical coherence tomography
Time frame: From baseline to month 6 and 12
Mean number of injections
The mean number of injections
Time frame: From baseline to month 12
Mean treatment interval between injections
The mean treatment interval (weeks) between injections
Time frame: From baseline to month 12
Proportion (%) of subjects who gain ≥ 15 letters in best corrected visual acuity
The proportion (%) of subjects who gain ≥ 15 letters in best corrected visual acuity on the early treatment diabetic retinopathy chart
Time frame: Compared with baseline at month 6 and 12
Changes of total area (mm^2)of nonperfusion within the ETDRS grid using fluorescein angiography and optical coherence tomography angiography
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Yeungnam university hospital
Daegu, South Korea
RECRUITINGKyungpook National University Hospital
Daegu, South Korea
RECRUITINGChungnam National University Hospital
Daejeon, South Korea
RECRUITINGChonnam National University Hospital
Gwangju, South Korea
RECRUITINGChanges of total area (mm\^2) of nonperfusion within the ETDRS grid using fluorescein angiography and optical coherence tomography angiography
Time frame: From baseline to month 12