Anatomical and functional recurrence after dexamethasone intravitreal implants: a 6-month prospective study

Fortoul, Vincent; Denis, Philippe; Kodjikian, Laurent

doi:10.1038/eye.2015.36

Cited by 9 publications

(2 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…A DME recurrence rate of 21.6% (8/31 patients) has been reported previously for patients treated with DEX; however, these patients had not undergone surgery for cataracts [ 27 ]. A recurrence rate exceeding 90% has also been reported in patients by 180 days [ 28 ]. Similar injection intervals have been reported for chronic DME treated with DEX monotherapy, with Zandi et al (2017) reporting an interval of 138 ± 15 days [ 29 ].…”

Section: Discussionmentioning

confidence: 99%

Real-world experience on intravitreal dexamethasone implant in patients with macular edema scheduled to undergo cataract surgery

Lai

Kuo

2023

BMC Ophthalmol

View full text Add to dashboard Cite

Background Patients with pre-existing macular edema (ME) due to diabetes and retinal vein occlusions (RVO) make up a growing population receiving cataract surgery. Surgery is associated with an increased risk of worsening existing ME due to post-surgical inflammation that can be further exacerbated by pre-existing diabetic retinopathy (DR) and retinal vein occlusion. This study aimed to examine the pre-operative use of intravitreal dexamethasone (DEX) implants in patients with ME undergoing cataract surgery. Methods A retrospective study was conducted at National Cheng Kung University Hospital in Taiwan involving 19 eyes of 16 patients with DME or ME associated with RVO. All participants received a DEX implant at baseline and underwent phacoemulsification within 3 months after its insertion. Best-corrected visual acuity (BCVA), intraocular pressure (IOP) and central subfield thickness (CST) were evaluated. Results DEX implants reduced the CST from baseline (357.8 μm) to pre-surgery (280.8 μm). This reduction below baseline continued to month 6 post-surgery (319.4 μm). From baseline (16.15 mmHg), the mean IOP initially increased pre-surgery (17.78 mmHg) before returning to the baseline value at month 6 post-surgery (16.15 mmHg). All patients improved their BCVA from logMAR 0.943 on average at baseline to logMAR 0.532 at month 6 post-surgery. Conclusions The results of the study suggested that patients with ME could benefit from DEX implants before cataract surgery within 3 months to achieve sufficient postoperative inflammation management and limit ME deterioration. DEX implants did not increase IOP post-surgery and was similar to baseline levels.

show abstract

Section: Discussionmentioning

confidence: 99%

Real-world experience on intravitreal dexamethasone implant in patients with macular edema scheduled to undergo cataract surgery

Lai

Kuo

2023

BMC Ophthalmol

View full text Add to dashboard Cite

show abstract

“…When repeat treatment with DEX implant is indicated, the timing of re-treatment varies; however, on average, an interval shorter than 6 months is needed for sustained effectiveness [17][18][19][20]. For patients who received a second implant in this study, the mean time between the first and second implant was 155 days (approximately 5 months).…”

Section: Discussionmentioning

confidence: 99%

Dexamethasone intravitreal implant in retinal vein occlusion:real-life data from a prospective, multicenter clinical trial

Călugăru¹,

Călugăru²

2016

Graefes Arch Clin Exp Ophthalmol

View full text Add to dashboard Cite

Purpose To evaluate the relationship between duration of macular edema associated with retinal vein occlusion (RVO) and the achievement of vision gain in patients receiving dexamethasone intravitreal implant (DEX implant) in real-world clinical practice, and to define patterns of use of DEX implant and its efficacy and safety in the treatment of patients with RVO in clinical practice. Methods This prospective, open-label, multicenter, 6-month observational phase IV study conducted at 70 sites in Germany enrolled patients diagnosed with macular edema following branch or central RVO (BRVO, CRVO) who were given DEX implant. Follow-up visits and evaluations occurred in accordance with normal clinical practice. Re-treatment with DEX implant and use of other RVO therapies was at the discretion of the treating physician. The primary endpoint was mean change in best-corrected visual acuity (BCVA) from baseline at week 12.Results The analysis population consisted of 573 patients (64 % BRVO, 36 % CRVO). Patients received a mean of 1.17 DEX implant treatments during the study period; 84.3 % of patients received a single DEX implant and 19.9 % received adjunctive other RVO treatment. Among patients with analyzable BCVA data at baseline and week 12 (n = 351), mean change from baseline BCVA at week 12 was −0.16 (standard deviation, 0.30) logMAR (+7.8 approximate Early Treatment Diabetic Retinopathy Study [ETDRS] letters) (p < 0.001), and 33.9 % of patients had gained at least 3 lines in BCVA from baseline. Mean change from baseline BCVA at week 12 was +9.5, +7.3, and +5.4 approximate ETDRS letters in patients with macular edema duration < 90 days, from 90 to 180 days, and >180 days respectively. Improvement in BCVA through week 24 and decreases in central retinal thickness were seen in both BRVO and CRVO. The most common adverse drug reaction was increased intraocular pressure. No glaucoma incisional surgeries were required. Conclusions DEX implant was effective in improving BCVA and central retinal thickness in patients with BRVO and CRVO in real-world clinical practice. The largest gains in BCVA over 6 months occurred in patients with recent onset macular edema, confirming the benefit of early treatment. DEX implant was well tolerated and had an acceptable safety profile.

show abstract

Retinal vein occlusion and the use of a dexamethasone intravitreal implant (Ozurdex®) in its treatment

Garweg

Zandi

2016

Graefes Arch Clin Exp Ophthalmol

View full text Add to dashboard Cite

PurposeTo review published data pertaining to the clinical experience with a dexamethasone intravitreal implant (Ozurdex®) with a view to establishing a clinically based therapeutic regime.MethodsA PubMed search using the MeSH terms “retinal vein occlusion” and either “pathophysiology” or “dexamethasone intravitreal implant” was undertaken for manuscripts published until August 2015. The analysis included studies involving minimally 15 patients under a prospective design or 30 under a retrospective design, a minimal follow up of 6 months, and at least 2 intravitreal Ozurdex® injections per eye.ResultsIn the vast majority of eyes, satisfactory outcomes were achieved with retreatment intervals of between 3 and 5 months. Initial evidence indicates a similar efficacy compared to anti-VEGF therapies as a first-line treatment. Safety concerns associated with the long-term and repeated use of Ozurdex® are not borne out by clinical findings: its implantation is not associated with a sustained increase in intraocular pressure (IOP) over time or with the number of applications.ConclusionCompared with anti-VEGF therapies, the burden of retreatment is reduced. In patients with chronic macular edema not responsive to repetitive anti-VEGF therapies, the outcome after dexamethasone implant treatment is encouraging. However, these results are achieved at the expense of side effects typically associated with steroids: in up to 20 % of the Ozurdex®-treated patients, an elevation in IOP, which could be medically controlled in the majority of cases, and cataract formation or progression was observed.

show abstract

Anatomical and functional recurrence after dexamethasone intravitreal implants: a 6-month prospective study

Cited by 9 publications

References 18 publications

Real-world experience on intravitreal dexamethasone implant in patients with macular edema scheduled to undergo cataract surgery

Real-world experience on intravitreal dexamethasone implant in patients with macular edema scheduled to undergo cataract surgery

Dexamethasone intravitreal implant in retinal vein occlusion:real-life data from a prospective, multicenter clinical trial

Retinal vein occlusion and the use of a dexamethasone intravitreal implant (Ozurdex®) in its treatment

Contact Info

Product

Resources

About