Pseudophakic macular edema in nondiabetic and diabetic patients without diabetic retinopathy treated with intravitreal dexamethasone implant

BACKGROUND: The purpose of this study was to compare the impact of intravitreal dexamethasone (DEX) implant during a 12-month period in nondiabetic and diabetic patients without diabetic retinopathy (DR) as a treatment for refractory pseudophakic cystoid macular edema (PCME) following prior treatment with topical nepafenac 0.1% and prednisolone 1%. METHODS: Forty-two consecutive medical records of patients diagnosed with PCME after uneventful cataract surgery were included. The outcomes measured included best corrected visual acuity (BCVA) and central foveal thickness (CFT). Linear regression analysis was statistically applied. RESULTS: Following topical treatment, nondiabetic and diabetic subjects presented a mean ± SD gain of − 0.11 ± 0.11 and − 0.18 ± 0.11 BCVA logMAR and a CFT reduction of − 43.42 ± 53.66 µm and − 58.76 ± 36.28 µm, respectively. The mean BCVA gain at month 12 subsequent to DEX implantation was − 0.35 ± 0.17 in nondiabetic (p < 0.001) and − 0.55 ± 0.26 in diabetic patients (p < 0.001), with CFT reductions of − 195.71 ± 93.23 µm (p < 0.001) and − 260.81 ± 198.69 µm (p < 0.001), respectively. Patients who responded with better VA after topical treatment presented better visual outcomes at month 12 following DEX implantation (r(2) = 0.46; rho = − 0.71, p < 0.01). CONCLUSION: Nondiabetic and diabetic patients without DR demonstrated similar results after DEX implant after combined topical therapy, suggesting that selected diabetic patients may have a response comparable to that of nondiabetic patients with PCME.