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

Sorkin, Nir; Loewenstein, Anat; Habot‐Wilner, Zohar; Goldstein, Michaela

doi:10.1159/000360304

Cited by 19 publications

(7 citation statements)

References 34 publications

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“…Two previous studies have reported that intravitreal DEX implant treatment provides both functional and anatomic improvements in the treatment of diabetic, retinal vein occlusion, and uveitis-related macular edema in their study, including groups similar to our research 1,15 . Unlike these studies, retinal vein occlusions were evaluated in two different groups as branch and central in our study.…”

Section: Discussionsupporting

confidence: 77%

Efficacy of dexamethasone implant in the treatment of macular edema due to different etiologies

Öztürk

Esener

Gündüz

2020

Cukurova Medical Journal

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Öz Purpose: The aim of this study was to evaluate the effectiveness of intravitreal DEX implant injection in the treatment of macular edema due to four different etiologies. Materials and Methods: This is a retrospective and case control study. A total of 177 patients who underwent intravitreal DEX implant between 2014 and 2018 for four different etiologies, which are diabetic retinopathy (DR), branch retinal vein occlusion (BRVO), central retinal vein occlusion (CRVO) and posterior uveitis (PU), were included in the study. Best-corrected visual acuity (BCVA) and central macular thickness (CMT) were evaluated in pre-injection, 1st, 3rd, and 6th months post-injection. Results: Eighty-one patients (45.8%) had DR, 44 (24.9%) had BRVO, 35 (19.8%) had CRVO, and 17 (9.6%) had PU. There was a statistically significant difference in BCVA in the DR, BRVO and PU groups after the injection, but no significant difference was observed in the CRVO group. It is observed that there was a statistically significant decrease in CMT in all groups after the injection. The change in CMT in the 1st month was 153.4 ± 137 µm in the DR group, 161.1 ± 151 µm in the BRVO, 270.5 ± 189 µm in the CRVO and 142.2 ± 174 µm in the PU group. Conclusion: The intravitreal DEX implant reduces the CMT in patients with macular edema secondary to various etiologies and improves BCVA in patients with macular edema secondary to various etiologies except for patients with CRVO. Amaç: Dört farklı etyolojiye bağlı gelişen maküler ödeminin tedavisinde intravitreal DEX implant enjeksiyonunun etkinliğini değerlendirmek. Gereç ve Yöntem: Bu bir retrospektif vaka kontrol çalışmasıdır. Bu çalışmaya 2014-2018 arasında diyabetik retinopati (DR), branş retinal ven oklüzyonu (BRVO), santral retinal ven oklüzyonu (CRVO) ve posterior üveit (PU) olmak üzere dört farklı etiyolojiden köken alan intravitreal DEX implant uygulaması yapılmış 177 hasta dahil edilmiştir. En iyi düzeltilmiş vizüel aküite (BCVA) ve merkezi makula kalınlığı (CMT) enjeksiyon öncesi, enjeksiyon sonrası 1., 3. ve 6. aylarda değerlendirildi. Bulgular: Seksen bir hastada DR (%45.8), 44 BRVO (%24.9), 35 CRVO (%19.8) ve 17 PU (%9.6) vardı. Enjeksiyondan sonra DR, BRVO ve PU gruplarında BCVA'da istatistiksel olarak anlamlı bir fark vardı, ancak CRVO grubunda anlamlı bir fark gözlenmedi.. Enjeksiyondan sonra tüm gruplarda CMT'de istatistiksel olarak anlamlı bir azalma olduğu gözlenmiştir. Bir ayda CMT'deki değişiklik DR grubunda 153.4 ± 137 µ m, BRVO'da 161.1 ± 151 µ m, CRVO'da 270.5 ± 189 µ m ve PU grubunda 142.2 ± 174 µ m idi. Sonuç: İntravitreal DEX implantı, çeşitli etiyolojilere sekonder maküler ödemli hastalarda CMT'yi azalttığı, CRVO olan hastalar hariç çeşitli etiyolojilere ikincil olarak maküler ödemli hastalarda BCVA'yı iyileştirdiği sonucuna varılmıştır.

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Section: Discussionsupporting

confidence: 77%

Efficacy of dexamethasone implant in the treatment of macular edema due to different etiologies

Öztürk

Esener

Gündüz

2020

Cukurova Medical Journal

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“…As shown in previous studies, Ozurdex is also effective in persistent macular edema of variable etiologies such as retinal vein occlusion, uveitis or DME [11,12. ]The extended-release system Novadur® allows maintaining efficacy beyond the fourth month with a single injection.…”

Section: Discussionmentioning

confidence: 92%

Efficacy and Safety of Intravitreal Dexamethasone Implant in Patients with Diabetic Macular Edema

Guigou¹,

Pommier²,

Meyer³

et al. 2015

Ophthalmologica

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Purpose: To evaluate the efficacy and safety of intravitreal implant of dexamethasone (Ozurdex®) in diabetic macular edema (DME). Methods: This was a retrospective multicenter noncomparative study. Seventy-eight patients with DME followed for at least 6 months were included (P1.5 Network). Best-corrected visual acuity (BCVA), central retinal thickness (CRT), intraocular pressure (IOP) and cataract progression were studied at baseline and then at 1, 2, 4 and 6 months. Results: The mean CRT decrease from baseline was 145.2 µm at 6 months. The mean BCVA improvement from baseline was 6.7 at 6 months. An increase in IOP was observed for 11.7% of patients, and all patients were managed by topical treatment. No glaucoma or cataract surgery was necessary, and no endophthalmitis was reported. Conclusions: One injection of Ozurdex has an anatomical and functional effectiveness for the treatment of DME. Side effects were rare and manageable in our practice.

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“…Several studies have shown the efficacy of intravitreal steroids in DME. [12][13][14] In real life, intravitreal antiVEGF are more commonly used for diabetic macular edema and intraocular steroids are considered in a certain subset of patients with pseudophakia, recalcitrant edema, or systemic vascular comorbidities where anti VEGF agents are relatively contraindicated. We present here the results of intravitreal dexamethasone implant in treatment naïve DME.…”

Section: Introductionmentioning

confidence: 99%

Efficacy and safety of intravitreal dexamethasone implant in treatment naïve eyes with diabetic macular edema: Real world experience

Ratra

Sharma²,

Dalan

2020

European Journal of Ophthalmology

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Purpose: To evaluate the efficacy and safety of intravitreal dexamethasone implant in treatment naïve eyes with diabetic macular edema (DME). Methods: A retrospective analysis of treatment naïve eyes with DME which received intravitreal dexamethasone implant between January 2016 and March 2018 was done. Demographic details of the patients, ocular examination findings at baseline and on follow up visits were noted. Morphological features of DME and central macular thickness were noted on optical coherence tomography at each visit. The details regarding additional treatment for macular edema on follow up were noted. Results: Sixty five eyes were included in the study. The mean age was 59.14 ± 9.59 years. The follow up ranged from 6 to 48 months. Psuedophakic eyes showed visual improvement whereas the phakic eyes showed stable vision. The central foveal thickness showed significant reduction ( p = 0.05) in all the eyes. The best corrected visual acuity at final follow up (+0.65 logMAR) was slightly less as compared to baseline (+0.62 logMAR). Retreatment was needed in 37% eyes and antiglaucoma medications in 8% eyes. Cataract progression was noted in 24 eyes (37%); 17 eyes (26.1%) underwent surgery. Notably, 27 eyes (41.5%) had some degree of macular ischemia at baseline. And five eyes (7.7%) showed progression of retinopathy leading to vitreous hemorrhage. Conclusion: Dexamethasone implant is helpful in reducing the macular thickness and stabilizing the vision in treatment naïve DME; requiring less number of treatment sessions. However, it does not prevent progression of diabetic retinopathy. The visual improvement may be affected by cataract and macular ischemia.

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

Cited by 19 publications

References 34 publications

Efficacy of dexamethasone implant in the treatment of macular edema due to different etiologies

Efficacy of dexamethasone implant in the treatment of macular edema due to different etiologies

Efficacy and Safety of Intravitreal Dexamethasone Implant in Patients with Diabetic Macular Edema

Efficacy and safety of intravitreal dexamethasone implant in treatment naïve eyes with diabetic macular edema: Real world experience

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