Efficacy and Safety of Dexamethasone Intravitreal Implant for Treatment of Refractory Macular Edema Secondary to Retinal Vein Occlusion in Taiwan

Sheu, Shwu‐Jiuan; Wu, Tsung-Tien; Horng, Yu-Harn

doi:10.1089/jop.2014.0119

Cited by 13 publications

(9 citation statements)

References 29 publications

(30 reference statements)

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“…A large number of studies have shown that intravitreal steroid injections are effective for treating BRVO-ME [17][18][19][20][21][22][23]. The effectiveness of such steroid injections stems from their anti-inflammatory properties and their capacity to stop the release of VEGF.…”

Section: Discussionmentioning

confidence: 99%

“…The effectiveness of such steroid injections stems from their anti-inflammatory properties and their capacity to stop the release of VEGF. Moreover, previous studies have proven Ozurdex to be a well-tolerated, efficacious treatment [17][18][19][20][21][22][23]. More specifically, the relatively long half-life of Ozurdex may yield substantial benefits compared to other treatments by allowing for a significantly longer interval between injections and, relatedly, better patient compliance [19].…”

Section: Discussionmentioning

confidence: 99%

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Risk factors for repeated dexamethasone intravitreal implant therapy for macular edema due to treatment-naïve branch retinal vein occlusion

Huang

Lin

Chen³

et al. 2021

BMC Ophthalmol

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Background This study evaluated the effects of dexamethasone intravitreal implant on treatment-naïve branch retinal vein occlusion (BRVO)-induced macular edema (ME), and the risk factors for earlier repeated treatment. Methods Patients treated from 2013 to 2016 were enrolled. The patients’ demographics, medical history, best-corrected visual acuity (BCVA), and central retinal thickness (CRT) were recorded. Risk factors for repeated treatment were identified using a Cox proportional hazard model and logistic regression. Results 29 patients (mean age: 58.64 ± 13.3 years) were included; 44.8% received only one injection, while 55.2% received two or more. The mean initial CRT was 457.8 ± 167.1 μm; the peak CRT and final CRT improved significantly to 248.9 ± 57.9 μm and 329.2 ± 115.1 μm, respectively. The peak BCVA improvement and final improvement were 29.5 ± 23.5 approximate ETDRS letters and 19.8 ± 24.4 letters, respectively, with 62.1% of patients improving by more than 15 letters. Older age, higher initial CRT, and diabetes were the risk factors for multiple injections. Conclusion Dexamethasone intravitreal implant results in significant peak CRT and BCVA improvements, while older age, higher initial CRT, and diabetes are risk factors for repeated injections. The optimal retreatment schedule for these patients should be further explored.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Risk factors for repeated dexamethasone intravitreal implant therapy for macular edema due to treatment-naïve branch retinal vein occlusion

Huang

Lin

Chen³

et al. 2021

BMC Ophthalmol

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“…Risk factors for suboptimal response include older age, shorter occlusion distance from the optic nerve, longer pre-treatment duration, and larger areas of non-perfusion. A study of eyes with macular edema from RVO that were refractory to treatment with an anti-VEGF agent revealed that treatment with a long-acting dexamethasone implant showed a small improvement in both optical coherence tomography (OCT) and vision 50 .…”

Section: New Advances In the Treatment Of Rvomentioning

confidence: 99%

Recent advances in understanding and managing retinal vein occlusions

Esmaili

Boyer

2018

F1000Res

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Retinal vein occlusions are the second most common form of retinal vascular disease. Previously, laser treatment for branch retinal vein occlusion and intravitreal triamcinolone acetonide for central retinal vein occlusion were the standard of care. Recent studies have demonstrated that anti-vascular endothelial growth factor (anti-VEGF) agents have a superior safety and efficacy profile for the treatment of both branch and central retinal vein occlusions. The use of wide-field fluorescein angiography has also allowed better visualization of the retinal periphery. Despite the better documentation of retinal non-perfusion, laser photocoagulation to the areas of non-perfusion does not seem to result in a reduction of macular edema or reduction in treatment burden and has been relegated to patients who develop rubeosis or neovascularization of the retina. More recently, several studies have demonstrated the use of a long-acting dexamethasone implant administered intravitreally or triamcinolone administered in the suprachoroidal space as a viable approach to treat retinal vein occlusion.

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“…[ 37 ] A recent retrospective study has also demonstrated that dexamethasone intravitreal implants are not only effective as a first-line agent for CRVO-related macular edema but also for refractory cases as well. [ 38 ] Corticosteroid treatments have demonstrated the ability to improve visual acuity in the short-term and have proven, especially useful in pseudophakic patients or patient who do not experience significant IOP elevation with local steroid use. They are a useful option for the treatment of macular edema due to retinal vein occlusion.…”

Section: Other Treatment Options For Central Retinal Vein Occlusionmentioning

confidence: 99%

Management of macular edema due to central retinal vein occlusion – The role of aflibercept

Rhoades

Dickson

Nguyen

et al. 2017

Taiwan J Ophthalmol

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Central retinal vein occlusion (CRVO) can cause vision loss. The pathogenesis of CRVO involves a thrombus formation leading to increased retinal capillary pressure, increased vascular permeability, and possibly retinal neovascularization. Vision loss due to CRVO is commonly caused by macular edema. Multiple treatment modalities have been used to treat macular edema. Currently, the most common therapy used is intravitreal inhibition of vascular endothelial growth factor (VEGF). The three most widely used agents are aflibercept, bevacizumab, and ranibizumab and they are effective at blocking VEGF. In addition, intraocular steroids can be used to treat macular edema. This review will briefly cover the treatment options and discuss in greater detail the efficacy and safety of aflibercept.

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Efficacy and Safety of Dexamethasone Intravitreal Implant for Treatment of Refractory Macular Edema Secondary to Retinal Vein Occlusion in Taiwan

Abstract: The DEX implant is an effective and safe treatment for ME, secondary to RVO, including refractory ME.

Cited by 13 publications

References 29 publications

Risk factors for repeated dexamethasone intravitreal implant therapy for macular edema due to treatment-naïve branch retinal vein occlusion

Risk factors for repeated dexamethasone intravitreal implant therapy for macular edema due to treatment-naïve branch retinal vein occlusion

Recent advances in understanding and managing retinal vein occlusions

Management of macular edema due to central retinal vein occlusion – The role of aflibercept

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