Effectiveness and safety of dexamethasone implants for post-surgical macular oedema including Irvine-Gass syndrome: the EPISODIC study

Abstract

Ozurdex would appear to be an interesting alternative therapy for treating post-surgical macular oedema, including Irvine-Gass syndrome refractory to first-line treatments.

Dexamethasone 0.7 mg implants in the management of pseudophakic cystoid macular edema

“…Majority of patients remain asymptomatic without active inflammation on fundus examination and optical coherence tomography (OCT) (3) . However, subclinical PCME is detected in almost 30% of patients with postsurgical angiography and a further 11%-41% patients with OCT (4) . The pathogenesis of PCME remains obscure.…”

“…Inflammatory mediators disrupt the blood-aqueous barrier (BAB) and blood-retinal barrier (BRB), leading to an amplification of retinal permeability and the development of PCME (2,5) . No recent significant studies have been conducted to establish the best therapeutic options for treating this disorder (4) . Non-steroidal anti-inflammatory drugs (NSAIDs) and corticosteroids represent the most common first-line treatments (4,6) .…”

“…No recent significant studies have been conducted to establish the best therapeutic options for treating this disorder (4) . Non-steroidal anti-inflammatory drugs (NSAIDs) and corticosteroids represent the most common first-line treatments (4,6) . Antiangiogenic therapy, sub cutaneous injections of interferon α2a, hyperbaric therapy, and vitrectomy are also therapeutic options (4,5) .…”

“…The dexamethasone implant (DEX implant; Ozurdex; Allergan, USA) is a 0.7 mg biodegradable intravitreal implant that delivers dexamethasone into the vitreous and retina. The drug acts on all inflammatory mediators and has been approved by the US Food and Drug Administration (FDA) for the treat ment of macular edema (ME) secondary to retinal vein occlusion (RVO) and for non-infectious posterior uveitis (4) . The DEX implant has also been indicated for the treatment of diabetic ME in patients who are pseudophakic or are phakic and scheduled for cataract surgery (4) .…”

“…Non-steroidal anti-inflammatory drugs (NSAIDs) and corticosteroids represent the most common first-line treatments (4,6) . Antiangiogenic therapy, sub cutaneous injections of interferon α2a, hyperbaric therapy, and vitrectomy are also therapeutic options (4,5) . The dexamethasone implant (DEX implant; Ozurdex; Allergan, USA) is a 0.7 mg biodegradable intravitreal implant that delivers dexamethasone into the vitreous and retina.…”