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Abstract

EFFECT OF INTRAVITREAL DICLOFENAC ON DIABETIC MACULAR EDEMA WHICH UNRESPONSIVE TO INTRAVITREAL BEVACIZUMAB

Mehmet Demir*, Efe Can, Sönmez Cinar, Hakan Sensöz, Atilla Demir

ABSTRACT

Background: Diabetic retinopathy (DR) is the leading cause of blindness in working-age persons around the world. Visual impairment is the most commonly a consequence of diabetic macular edema (DME). The cause of DME is multifactorial. Blood vessel damage, vascular dilatation, inflammatory changes, increase in expression of ICAM-1 (intercellular adhesion molecule 1). Optical coherence tomography (OCT) has become the gold standard used to objectively assess and quantify DME, central macular thickness (CMT) is the most common OCT measurement used for comparative purposes in recent clinical trials. Objective: To evaluate the effect of intravitreal diclofenac in patients with diabetic macular edema which unresponsive to intravitreal bevacizumab. Material and Methods: In this non comparative case series 14 eyes of 13 patients with diabetic macular edema which unresponsive to 3 intravitreal bevacizumab injections. All patients received intravitreal diclofenac 500 μg/ 0.1 mL into vitreous in the operation room via pars plana. Pre and post injection values of intraocular pressure (IOP), best corrected visual acuity (BCVA) and CMT (central macular thickness) were compared after injection at 3 months. Results: The mean age of 13 (7 female, 6 male) patients was 62.6 ±10.2 years old. Pre and post injection mean BCVA were 1.03 ± 0.59; 1.18 ± 0.55 logarithm of the minimum angle of resolution (logMAR), (p= 0.146), respectively. Pre and post injection mean values of CMT were 431 ± 71 μm; 397 ± 110 μm (p= 0.161), respectively. Conclusion: Intravitreal diclofenac has no significant effect on visual acuity and central macular thickness in patients with diabetic macular edema whic unresponsive to 3 intravitreal bevacizumab injections.

Keywords: central macular thickness, diabetic macular edema, intravitreal diclofenac.


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