Intravitreal Dexamethasone Implant for the Treatment of Refractory Macular Edema in Retinal Vascular Diseases

Abstract

The dexamethasone implant improved macular edema in refractory cases resulting in statistically significant improvements in best-corrected visual acuity and central macular thickness that remained stable to 3 months and 6 months, respectively.

Effectiveness and Safety of Intravitreal Dexamethasone Implant (Ozurdex) in Patients with Diabetic Macular Edema: A Real-World Experience

“…In a real-life study, IOP elevations of at least 10 mm Hg were reported in 7.9% of eyes [24], very similar to the rate we found in the current study (7.4%). On the other hand, some studies reported higher frequencies of IOP elevations: for example, an elevation of at least 20 mm Hg was registered by Alshahrani et al [15] in 26% of eyes, and an elevation of at least 25 mm Hg was reported by Bonnin et al [16] in 21% of eyes. Although these different percentages among studies may be due to variations in patient selection or the frequency of assessment, in most cases the authors found IOP elevations to be transient and amenable to topical treatment [18, 24].…”

“…In a retrospective study from Spain with 58 patients, a mean gain of 7 letters was reported at 1 month [23]. Similarly good results were reported by a second Spanish group, with combined data from patients from Saudi Arabia; in this retrospective series of 53 eyes with DME ( n = 26) or refractory macular edema from central or branch retinal vein occlusion ( n = 27), the baseline BCVA of 0.89 ± 0.97 logMAR improved significantly to 0.61 ± 0.41 logMAR at the first month and 0.5 ± 0.46 logMAR at 3 months [15]. Likewise, improvements of similar magnitude at various time points were reported in retrospective series from France [16, 18].…”

“…In the naïve eyes, the BCVA improved from 0.58 ± 0.25 to 0.44 ± 0.33 logMAR ( p = 0.05). In these retrospective studies, statistically significant decreases in retinal thickness were reported, and the most frequently reported adverse event was increased IOP in 13–26% of cases [15, 16, 18]. In the randomized prospective trial that assessed treatment with Ozurdex with a follow-up of 3 years (MEAD Study), a total of 1,048 patients with DME, a BCVA of 20/50 to 20/200 Snellen equivalent, and a CRT of 300 µm or more were randomized to two doses of the implant (0.7 or 0.35 mg), or to a sham procedure.…”

“…Moreover, these implants have the potential to reduce the costs and overall treatment burden associated with other therapies [14]. Although an intravitreal dexamethasone implant (Ozurdex at a dose of 0.7 mg; Allergan Inc., Irvine, CA, USA) has been available in Brazil since 2012, unlike other countries [15-20] no clinical studies have been reported thus far assessing the use of this product specifically in the treatment of DME. We aimed to assess the real-world use of this product in order to further characterize its effectiveness and safety among patients with DME treated in Latin America.…”

Short-term Effect of Intravitreal Dexamethasone Implant on Diabetic Macular Edema with Epiretinal Membrane

“…특히, 덱사메타손 임플 란트(Ozurdex ® , Allergan, Irvine, CA, USA)는 한 번의 삽입술 로 6개월까지 유리체내에 존재하며 [15], 21.5-22.2%의 환자에서 3줄 이상의 시력 상승을 보고하고 있다 [13,16]. 이러한 덱사메타 손 임플란트는 항혈관내피세포성장인자치료에 비해 긴 작용 시 간과 함께 유사한 치료 효과를 보여주었고 [17,18], 항혈관내피세 포성장인자 치료에 반응하지 않는 난치성(refractory) 당뇨황반 부종 환자에게도 효과가 있는 것으로 알려지면서 [19,20], 당뇨황 반부종 환자에서 그 적응증을 넓혀 가고 있다. 당뇨황반부종에서 유리체황반경계면 이상은 흔히 발견되는데 약 27-34% 정도에서 망막전막이 동반되는 것으로 보고되고 있 다 [21,22].…”