Dexamethasone Intravitreal Implant for Treatment of Uveitic Persistent Cystoid Macular Edema in Vitrectomized Patients

Adán, Alfredo; Pelegrín, Laura; Rey, Amanda; Llorenç, Víctor; Mesquida, Marina; Molins, Blanca; Ríos, José; Keller, Johannes

doi:10.1097/iae.0b013e31827e247b

Cited by 83 publications

(34 citation statements)

References 16 publications

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“…Average CME duration prior to injection was 12 months. Changes in CMT were comparable to our study [31]. Our study did not include vitrectomized eyes.…”

Section: Discussionsupporting

confidence: 72%

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Intravitreal Dexamethasone Implant in Patients with Persistent Macular Edema of Variable Etiologies

et al. 2014

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Purpose: To examine the effect of an intravitreal dexamethasone drug delivery system (DEX-DDS) in the treatment of persistent cystoid macular edema (CME) of different etiologies. Methods: Thirty-seven eyes with persistent CME were treated with DEX-DDS and analyzed for changes in best-corrected visual acuity (BCVA) and optical coherence tomography. Eyes were categorized into three groups: diabetic macular edema (DME, n = 14), vein occlusion (n = 15) and uveitis (n = 7). Results: The mean follow-up was 22 ± 6.9 weeks. BCVA improved from 0.62 ± 0.38 to 0.35 ± 0.29 logMAR (p < 0.0001). Central macular thickness decreased by 184 ± 246 µm from baseline (p < 0.0001). In eyes where CME resolved and recurred, the average CME-free period was 11 weeks. The uveitis group showed faster CME resolution (2 weeks) and a longer CME-free period (20 weeks). Similar efficacy was shown for repeat DEX-DDS injections. The safety profile was good. Conclusion: DEX-DDS is beneficial in the treatment of persistent CME. In cases of uveitis, CME resolution is rapid, resulting in the longest effect duration, when compared with other CME etiologies.

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“…Average CME duration prior to injection was 12 months. Changes in CMT were comparable to our study [31]. Our study did not include vitrectomized eyes.…”

Section: Discussionsupporting

confidence: 72%

“…There is little evidence in the published literature of the effect of DEX-DDS in the treatment of edema persisting following other treatments [28,29,30,31,32,33]. The purpose of our study was to examine the effect of DEX-DDS in patients with severely recalcitrant CME that had a poor or short-term response to other treatment modalities.…”

Section: Introductionmentioning

confidence: 99%

Intravitreal Dexamethasone Implant in Patients with Persistent Macular Edema of Variable Etiologies

et al. 2014

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“…50 Among studies with patients having a mix of single or multiple implants and macular oedema, significant improvements in central retinal thickness were reported up to 12 months in one study, 50 with another study reporting significant improvements at 3 months but not at 6 months. 85 In terms of repeat implants, one study reported that after the second implant BCVA improved significantly by 1 month but then decreased, with a similar trend following up to six implants (not significant but small patient numbers). 18 Central retinal thickness and VH also showed a significant temporary improvement after the second implant, with similar (non-significant) improvements after the third and fourth implants.…”

Section: Dexamethasone Studiesmentioning

confidence: 99%

“…18,50,51,[79][80][81][82][83][84][85][86] This is based on data from the company submission for DEX; 43 the original study publications have not been examined because of time constraints. These data are included here as they provide some data on repeat implants, implants in both eyes and corticosteroid reduction, which were not assessed in the HURON trial.…”

Section: Dexamethasone Studiesmentioning

confidence: 99%

A systematic review and economic evaluation of adalimumab and dexamethasone for treating non-infectious intermediate uveitis, posterior uveitis or panuveitis in adults

Squires

Poku

Bermejo

et al. 2017

Health Technol Assess

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Declared competing interests of authors: Fahd Quhill has received personal fees from Allergan for participation in medical education and training, and has participated in advisory boards given his clinical expertise in the role of steroids in diabetic macular oedema. He has also received support from Allergan to attend international conferences.Published November 2017 DOI: 10.3310/hta21680 This report should be referenced as follows: This journal is a member of and subscribes to the principles of the Committee on Publication Ethics (COPE) (www.publicationethics.org/).Editorial contact: journals.library@nihr.ac.ukThe full HTA archive is freely available to view online at www.journalslibrary.nihr.ac.uk/hta. Print-on-demand copies can be purchased from the report pages of the NIHR Journals Library website: www.journalslibrary.nihr.ac.uk Criteria for inclusion in the Health Technology Assessment journalReports are published in Health Technology Assessment (HTA) if (1) they have resulted from work for the HTA programme, and (2) they are of a sufficiently high scientific quality as assessed by the reviewers and editors.Reviews in Health Technology Assessment are termed 'systematic' when the account of the search appraisal and synthesis methods (to minimise biases and random errors) would, in theory, permit the replication of the review by others. HTA programmeThe HTA programme, part of the National Institute for Health Research (NIHR), was set up in 1993. It produces high-quality research information on the effectiveness, costs and broader impact of health technologies for those who use, manage and provide care in the NHS. 'Health technologies' are broadly defined as all interventions used to promote health, prevent and treat disease, and improve rehabilitation and long-term care.The journal is indexed in NHS Evidence via its abstracts included in MEDLINE and its Technology Assessment Reports inform National Institute for Health and Care Excellence (NICE) guidance. HTA research is also an important source of evidence for National Screening Committee (NSC) policy decisions.For more information about the HTA programme please visit the website: http://www.nets.nihr.ac.uk/programmes/hta This reportThe research reported in this issue of the journal was commissioned and funded by the HTA programme on behalf of NICE as project number 15/64/07. The protocol was agreed in June 2016. The assessment report began editorial review in December 2016 and was accepted for publication in May 2017. The authors have been wholly responsible for all data collection, analysis and interpretation, and for writing up their work. The HTA editors and publisher have tried to ensure the accuracy of the authors' report and would like to thank the reviewers for their constructive comments on the draft document. However, they do not accept liability for damages or losses arising from material published in this report.This report presents independent research funded by the National Institute for Health Research (NIHR). The views and opinions expre...

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“…25 Using a slow-release DXM implant (Ozurdex), a complete resolution of the vitreous inflammation has been observed after 6 months in 47% of 77 uveitis patients with an initial vitreous Tyndall effect of at least 1.5+. 26 A significant improvement in persistent inflammatory ME has been shown in terms of centrofoveal thick ness 27 and VA in more than 85% of patients at 4 months. 28 The efficacy duration may differ and a median time to recurrence is 5 months.…”

Section: Corticosteroidsmentioning

confidence: 99%

Uveitic macular edema

Fardeau

Champion

Massamba

et al. 2016

Eye

112

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Dexamethasone Intravitreal Implant for Treatment of Uveitic Persistent Cystoid Macular Edema in Vitrectomized Patients

Abstract: In this small case series of eyes with limited follow-up, treatment with dexamethasone intravitreal implant injection for uveitic macular edema in vitrectomized eyes was associated with favorable visual outcomes and had an acceptable safety profile.

Cited by 83 publications

References 16 publications

Intravitreal Dexamethasone Implant in Patients with Persistent Macular Edema of Variable Etiologies

Intravitreal Dexamethasone Implant in Patients with Persistent Macular Edema of Variable Etiologies

A systematic review and economic evaluation of adalimumab and dexamethasone for treating non-infectious intermediate uveitis, posterior uveitis or panuveitis in adults

Uveitic macular edema

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