Effect of Dexamethasone Intravitreal Implant in Persistent Macular Edema: Systematic Review and Meta-analysis
Sayyed amirpooya Alemzadeh1 *, Bita Mehravi2 , Samiri Chaybakhsh1 , Parsa Panahi3 , Farnoosh seirafianpour3 , Milad shemshadi3 , Zahra Bibak3
- Eye Research Center, The Five Senses Institute Rassoul Akram Hospital , Iran University of Medical Sciences, Tehran, Iran
- Department of Medical Nanotechnology, Faculty of Advanced Technologies in Medicine, Iran University of Medical Sciences, Tehran, Iran
- Student Research Committee, school of medicine, Iran University of Medical Sciences, Tehran, Iran
Abstract: To evaluate the effectiveness of intravitreal dexamethasone (DEX) implant treatment for persistent macular edema (ME) secondary to diabetic retinopathy, retinal vein occlusion, and age-related macular degeneration
Methods: The PubMed, Embase, Cochrane Library, and Web of Science databases were comprehensively searched for relevant publications. Persistent ME was defined as the presence of ME for 3 months or after at least 3 intravtreal injections of anti-vascular endothelial growth factor (anti-VEGF). Best-corrected visual acuity (BCVA) and central macular thickness (CMT) were considered as an outcome. Evaluation time was considered 12 months For CMT and 9 months for BCVA after intravitreal injection of DEX, If the information in the mentioned times were missing, the nearest evaluation times were included in the analysis. Besides the effect of the intervention, the effect of evaluation time was assessed to avoid bias in estimations. STATA 16 was used to analyze the data.
Results: A total of 18 published papers that were investigated the efficacy of DEX were analyzed. Meta-regression showed no statistically significant effect of evaluation time in our data. The mean of BCVA was changed to about 0.12 (95%CI: 0.04-0.2) LogMAR from baseline (P-value=0.027). The mean of CMT was changed to about 138.09 (95%CI: 104.41-171.76) from baseline. (p-value<0.001).
Conclusion: The study showed that the use of DEX in persistent ME have benefit in terms of decreasing CMT and increasing BCVA. However, improvement in BCVA may be clinically challenging.
