Effectiveness and safety of dexamethasone implants for postsurgical macular oedema including Irvine–Gass syndrome: the EPISODIC-2 study

Bellocq, David; Pierre-Kahn, Vincent; Matonti, F.; Burillon, C.; Voirin, Nicolas; Dot, Corinne; Akesbi, Jad; Milazzo, S.; Baillif, S.; Soler, V.; Wolff, Benjamin; Scemama, Claire; Malclès, Ariane; Weber, Michel; Kodjikian, Laurent

doi:10.1136/bjophthalmol-2016-308544

Cited by 55 publications

(44 citation statements)

References 31 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In a multicentre national case series of eyes (N = 100) receiving a dexamethasone 0.7 mg implant for postsurgical macular oedema, 37% of patients required only one dexamethasone implant during the first year and experienced no recurrence of the macular oedema in a follow‐up period of greater than 1 year. The significant improvement in visual acuity at 6 months was maintained at 12 months following treatment …”

Section: Treatmentmentioning

confidence: 80%

See 1 more Smart Citation

Cystoid macular oedema following cataract surgery: A review

Han

Patel

Squirrell

et al. 2019

Clinical Exper Ophthalmology

View full text Add to dashboard Cite

Pseudophakic cystoid macular oedema (PCMO) remains a significant cause of compromised postoperative vision in contemporary cataract surgery. Well‐established risk factors include intraoperative complications such as posterior capsule rupture and preoperative factors including: diabetes mellitus, uveitis, retinal vein occlusion, epiretinal membrane. The role of topical glaucoma medications in PCMO continues to be debated. Current treatment strategies largely target suppression of inflammation. Topical NSAIDs remain the mainstay in prophylaxis and treatment of PCMO. Topical corticosteroids are commonly used as monotherapy or in combination with NSAIDs. Unfortunately, high‐quality trials are notably lacking for other PCMO treatment modalities such as: periocular corticosteroids, orbital floor triamcinolone, intravitreal triamcinolone, corticosteroid implants, intravitreal bevacizumab and pars‐plana vitrectomy. A lack of consistency in defining PCMO and resolution of PCMO explains why even large systematic reviews may come to contradictory conclusions. This review explores the varied contemporary evidence‐base in relation to the aetiology, diagnosis, prophylaxis and treatment of PCMO.

show abstract

Section: Treatmentmentioning

confidence: 80%

“…The significant improvement in visual acuity at 6 months was maintained at 12 months following treatment. 53…”

Section: T a B L E 3 Management Of Pcmomentioning

confidence: 99%

Cystoid macular oedema following cataract surgery: A review

Han

Patel

Squirrell

et al. 2019

Clinical Exper Ophthalmology

View full text Add to dashboard Cite

show abstract

“…Bellocq et al in a multi-centre national case series of 100 eyes receiving a dexamethasone 0.7 mg implant for postsurgical macular oedema, noted that 37% of patients required only one dexamethasone implant during the first year and experienced no recurrence of the macular oedema in a follow-up period of greater than 1 year. The significant improvement in visual acuity at 6 months was maintained at 12 months following treatment [6].…”

Section: Lack Of Evidence For Treatment Optionsmentioning

confidence: 80%

“…A report by the American Academy of Ophthalmology in 2015 advised that peri-operative topical NSAIDs are effective in reducing the occurrence of pseudophakic CMO, may increase the speed of visual recovery postoperatively in diabetic patients, but do not alter long-term visual outcomes beyond 3 months [5]. [6,7,9,14,26,[31][32][33][34][35][36][37]. A recent review of CMO by McGhee's group in Auckland concluded that "there are limited evidence-based clinical studies available regarding successful treatment strategies, and there is substantial inconsistency between studies in terms of defining successful outcome measures, with some focusing on improvements as measured by OCT or fluorescein angiography vs visual acuity outcomes" [29].…”

Section: Discussionmentioning

confidence: 99%

“…CMO can also occur in the setting of uncomplicated cataract surgery, with published incidence rates ranging from 1.2-3.4% [5][6][7][8][9][10]. Known as Irvine-Gass syndrome for the past 60 years, patients commonly experience good A version of this study was an oral presentation at the Scottish Ophthalmological Club meeting in February 2020, accepted as a poster presentation at RCOphth Annual Congress, Birmingham, UK in May 2020 (postponed due to COVID-19 restrictions) and has been submitted as an oral presentation at the ESCRS annual meeting, Amsterdam, October 2020. vision in the immediate post-operative period, followed by a painless central visual deterioration a few weeks later [7].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

The incidence and management of persistent cystoid macular oedema following uncomplicated cataract surgery—a Scottish Ophthalmological Surveillance Unit study

Erikitola

Siempis

Foot

et al. 2020

Eye

View full text Add to dashboard Cite

Purpose Post-operative cystoid macular oedema (CMO) can cause deterioration of vision following routine cataract surgery. The incidence of persistent CMO (pCMO; defined as CMO present after 3 months) following uncomplicated surgery is uncertain. We wished to identify the incidence, management and visual outcomes of such patients. Methods A Scottish Ophthalmological Surveillance Unit (SOSU) questionnaire was sent monthly to every ophthalmic specialist in Scotland over an 18-month period from 1st January 2018 asking them to report all new patients with pCMO confirmed on OCT scanning following uncomplicated cataract surgery. A follow-up questionnaire was sent 9 months after initial presentation. Results Fourteen cases of pCMO were reported, giving an incidence of 2.2 cases of pCMO per 10,000 uncomplicated cataract surgeries. Mean age was 74.9 years (SD 10.2; range 44-86) with a male preponderance (72.7%). Two patients developed pCMO in each eye. Six cases (46.2%) had hypertension and one had diabetes. Three eyes required intracameral adjuncts (two iris hooks, one intracameral phenylephrine). Postoperative visual acuity (VA) at 3 months was logMAR 0.48 (0.2-0.8). Average mean central retinal thickness (CRT) at 3 months was 497microns (270-788). The most common initial treatment comprised topical steroids and topical NSAIDs (61.5%). Other management strategies included systemic steroids, intravitreal steroids and oral acetazolamide. At 1-year post-op, mean VA was logMAR 0.18 (0.1-0.3) with average mean CRT of 327microns (245-488). Conclusions We identified a low incidence of pCMO following uncomplicated cataract surgery in Scotland (0.02%), with inconsistent and variable management regimes. A nationally agreed treatment protocol is required.

show abstract

Intravitreales Dexamethason-Implantat zur Behandlung des persistierenden postoperativen Makulaödems nach Vitrektomie

et al. 2016

View full text Add to dashboard Cite

show abstract

Effectiveness and safety of dexamethasone implants for postsurgical macular oedema including Irvine–Gass syndrome: the EPISODIC-2 study

Abstract: The significant gain in BCVA from baseline achieved at month 6 was maintained at month 12 after intravitreal injection of dexamethasone implant. Naïve status seems to be a good predictive factor of treatment response.

Cited by 55 publications

References 31 publications

Cystoid macular oedema following cataract surgery: A review

Cystoid macular oedema following cataract surgery: A review

The incidence and management of persistent cystoid macular oedema following uncomplicated cataract surgery—a Scottish Ophthalmological Surveillance Unit study

Intravitreales Dexamethason-Implantat zur Behandlung des persistierenden postoperativen Makulaödems nach Vitrektomie

Contact Info

Product

Resources

About