Intravitreal Dexamethasone Implant in Retinitis Pigmentosa–related Cystoid Macular Edema

Mansour, Ahmad M.; Sheheitli, Huda; Küçükerdönmez, Cem; Sisk, Robert A.; Moura, Raphael; Moschos, Marilita M.; Lima, Luiz H.; Al-Shaar, Laila; Arévalo, J. Fernando; Maia, Maurício; Foster, Robert E.; Kayıkçıoğlu, Özcan; Kozák, Igor; Kurup, Shree K.; Zegarra, Hernando; Gallego-Pinazo, Roberto; Hamam, Rola N.; Bejjani, R.A.; Çınar, Esat; Erakgün, Ethem T.; Kimura, Alan; Teixeira, Anderson

doi:10.1097/iae.0000000000001542

Cited by 22 publications

(35 citation statements)

References 25 publications

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“…Intravitreal dexamethasone implants (Ozurdex) have recently been approved for the treatment of macular oedema related to retinal vein occlusion [ 176 ]. A recent small-scale study has also trialled use of dexamethasone implants for treatment of RP with associated cystoid macular oedema (CMO) [ 177 ]. They observed a reduction in CMO along with some restoration of retinal morphology with intravitreal steroid implants.…”

Section: Clinical Trialsmentioning

confidence: 99%

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Mechanisms of Photoreceptor Death in Retinitis Pigmentosa

Newton

Megaw

2020

Genes

133

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Retinitis pigmentosa (RP) is the most common cause of inherited blindness and is characterised by the progressive loss of retinal photoreceptors. However, RP is a highly heterogeneous disease and, while much progress has been made in developing gene replacement and gene editing treatments for RP, it is also necessary to develop treatments that are applicable to all causative mutations. Further understanding of the mechanisms leading to photoreceptor death is essential for the development of these treatments. Recent work has therefore focused on the role of apoptotic and non-apoptotic cell death pathways in RP and the various mechanisms that trigger these pathways in degenerating photoreceptors. In particular, several recent studies have begun to elucidate the role of microglia and innate immune response in the progression of RP. Here, we discuss some of the recent progress in understanding mechanisms of rod and cone photoreceptor death in RP and summarise recent clinical trials targeting these pathways.

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Section: Clinical Trialsmentioning

confidence: 99%

“…Further, about 50% of subjects showed significantly improved visual acuity for up to four months post injection. However, repeated injections were required to maintain the effects, with the increased associated risk of cataract formation and raised intraocular pressure [ 177 , 178 ].…”

Section: Clinical Trialsmentioning

confidence: 99%

Mechanisms of Photoreceptor Death in Retinitis Pigmentosa

Newton

Megaw

2020

Genes

133

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“…Cystoid macular edema (CME) is a relatively common complication of RP, developing in about 20% of patients [109,110]. Table 2 summarizes characteristics and main outcomes of case reports or small series evaluating the efficacy and safety of DEX implant in RP [111][112][113][114][115]. Additionally, a couple of studies tried to elucidate the role of Dex implant in the treatment of CME secondary to RP [115,116].…”

Section: Evidence Of the Efficacy Of Dex In Inherited Retinal Disordersmentioning

confidence: 99%

“…Table 2 summarizes characteristics and main outcomes of case reports or small series evaluating the efficacy and safety of DEX implant in RP [111][112][113][114][115]. Additionally, a couple of studies tried to elucidate the role of Dex implant in the treatment of CME secondary to RP [115,116]. Mansour et al, analyzed the outcomes of 45 eyes (34 patients) affected by CME secondary to RP treated with Ozurdex with a mean follow-up of 15.5 months [115].…”

Section: Evidence Of the Efficacy Of Dex In Inherited Retinal Disordersmentioning

confidence: 99%

Intravitreal Dexamethasone Implant as a Sustained Release Drug Delivery Device for the Treatment of Ocular Diseases: A Comprehensive Review of the Literature

et al. 2020

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Drug delivery into the vitreous chamber remains a great challenge in the pharmaceutical industry due to the complex anatomy and physiology of the eye. Intravitreal injection is the mainstream route of drug administration to the posterior segment of the eye. The purpose of this review is to assess the current literature about the widening use of the intravitreal 0.7 mg dexamethasone (Dex) implant, and to provide a comprehensive collection of all the ocular disorders that benefit from Dex administration. Although anti-vascular endothelial growth-factors (VEGFs) have been largely indicated as a first-choice level, the Dex implant represents an important treatment option, especially in selected cases, such as vitrectomized eyes or patients in whom anti-VEGF failed or are contraindicated. In this article, the safety profile as well as the list of the possible complications related to intravitreal Dex injection are also discussed.

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“…The previous reports on intravitreal steroid administration in eyes with RP-related CME [30][31][32][33][34][35][36][37][38][39] are summarised in Table 1. The treatment effect of dexamethasone implant can be seen in a case with bilateral RP-related CME (Figures 1 and 2).…”

Section: -30mentioning

confidence: 99%

Intravitreal Pharmacotherapy in the Treatment of Retinitis Pigmentosa-related Cystoid Macular Oedema

Dönmez¹,

Saatçi²

2017

European Ophthalmic Review

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P eripheral visual field constriction and night blindness are the main features of retinitis pigmentosa (RP). However, central vision is often impaired dramatically even in the early stages of the disease when macular complications such as cystoid macular oedema (CME) occur. The pathogenesis of RP-related CME is still not well explained. Therefore, several treatment alternatives such as topical, oral and systemic pharmacotherapy; laser photocoagulation and even vitreoretinal surgery are employed by the clinicians. In this review, we summarise the clinical data on intravitreal pharmacotherapeutic agents and focus mainly on the steroids and anti-vascular endothelial growth factor agents. KeywordsAflibercept, intravitreal injection, macula, macular oedema, Ozurdex ® , ranibizumab, retinitis pigmentosa, steroid, vascular endothelial growth factor Disclosure: Oya Donmez and Ali Osman Saatci have nothing to disclose in relation to this article. No funding was received for the publication of this article. This study involves a review of the literature and did not involve any studies with human or animal subjects performed by any of the authors Authorship: All named authors meet the International Committee of Medical Journal Editors (ICMJE) criteria for authorship for this manuscript, take responsibility for the integrity of the work as a whole and have given final approval for the version to be published.Open Access: This article is published under the Creative Commons Attribution Noncommercial License, which permits any non-commercial use, distribution, adaptation, and reproduction provided the original author(s) and source are given appropriate credit. 1,2 Night blindness together with the peripheral visual field loss is the most prominent clinical feature.1,2 Central vision is relatively spared up to the later stages of the disease process.3 However, when macular complications such as macular oedema arise, central vision is often dramatically impaired even in the early stages of the disease. The prevalence of cystoid macular oedema (CME) is reported to be 10-20% in the eyes of patients with RP. 4,5The pathogenesis of RP-related CME is still unclear. Blood-retinal barrier (BRB) impairment, retinal pigment epithelium (RPE) pump disturbance, inflammation, autoimmunity and vitreoretinal interface changes may be among the potential causes of CME. [6][7][8][9][10][11][12][13][14][15][16][17][18][19] Fishman et al. 6 examined 15 RP patients with vitreous fluorophotometry. All patients showed abnormally high concentrations of fluorescein within the vitreous which was a sign of BRB abnormality. Larsen et al. 7 demonstrated that BRB leakage was markedly increased in six RP patients with the help of ocular spectrofluorophotometry. Vinores et al. 9 investigated the immunohistochemical staining for albumin on paraffin sections of 22 normal and 29 RP eyes.Electron microscopic immunocytochemical staining for albumin was performed on additional six normal and nine RP-affected eyes. Two-thirds of the eyes with RP demonstrated extr...

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Intravitreal Dexamethasone Implant in Retinitis Pigmentosa–related Cystoid Macular Edema

Abstract: Best-corrected visual acuity improved up to 4 months in around half of the eyes. Eyes that benefited the most were pseudophakic, steroid nonresponsive, with large initial central macular thickness, and profuse fluorescein dye leakage.

Cited by 22 publications

References 25 publications

Mechanisms of Photoreceptor Death in Retinitis Pigmentosa

Mechanisms of Photoreceptor Death in Retinitis Pigmentosa

Intravitreal Dexamethasone Implant as a Sustained Release Drug Delivery Device for the Treatment of Ocular Diseases: A Comprehensive Review of the Literature

Intravitreal Pharmacotherapy in the Treatment of Retinitis Pigmentosa-related Cystoid Macular Oedema

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