Intravitreal Sustained-Release Steroid Implants for the Treatment of Macular Edema following Surgical Removal of Epiretinal Membranes

Hattenbach, Lars‐Olof; Springer-Wanner, Christina; Hoerauf, Hans; Callizo, Josep; Jungmann, Stephanie; Brauns, Thomas; Fulle, Gergana; Eichel, Sebastian; Koss, Michael; Kuhli-Hattenbach, Claudia

doi:10.1159/000464259

Cited by 31 publications

(36 citation statements)

References 22 publications

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“…On the other hand, in a case series of 5 patients, Taney et al [20] showed that intravitreal dexamethasone implant was beneficial for persistent macular edema after PPV for ERM, although repeated injections were needed. This is in line with the most recent study by Hattenbach et al [11] who found that intravitreal dexamethasone implant was effective in reducing CRT and improving BCVA in 39 eyes with ERM treated with PPV. They also reported that about 44% of the patients needed one repeat injection of dexamethasone implant after a mean duration of 6.9 months.…”

Section: Discussionsupporting

confidence: 92%

“…However, despite successful surgery, approximately 10–30% of the patients may not experience any improvement in visual acuity. Persistent macular edema is among the most common causes of poor visual outcome after PPV for ERM removal [10, 11]. …”

Section: Introductionmentioning

confidence: 99%

“…The most plausible theory pertains to the development of a postoperative inflammatory reaction with concomitant release of cytokines, resulting in the breakdown of the blood-aqueous barrier and consequent fluid accumulation [11, 12]. Therefore, concomitant administration of intravitreal triamcinolone acetonide after PPV and ERM removal has been reported to speed up and improve anatomical and functional outcome, decreasing the postoperative swelling of the retina [13, 14].…”

Section: Introductionmentioning

confidence: 99%

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Treatment of Macular Edema after Pars Plana Vitrectomy for Idiopathic Epiretinal Membrane Using Intravitreal Dexamethasone Implant: Long-Term Outcomes

et al. 2019

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Purpose: The aim of this study was to investigate the efficacy and safety of intravitreal dexamethasone implant for the treatment of macular edema after pars plana vitrectomy (PPV) for epiretinal membrane (ERM) removal. Methods: This prospective study included 27 patients who were diagnosed with macular edema after PPV for ERM removal and who were treated with either intravitreal dexamethasone implant (n = 15) or were observed without intervention (n = 12). Changes in best-corrected visual acuity (BCVA) and central retinal thickness (CRT) were assessed 1, 6, and 12 months after treatment. Results: Patients treated with intravitreal dexamethasone implant showed significant improvement in BCVA and reduction in CRT at months 1, 6, and 12 after treatment, while patients in the control group showed improvement that did not reach statistical significance. The two groups differed significantly in terms of BCVA and CRT at all time points of the follow-up period, in favor of the dexamethasone implant group. Eighty percent of the patients treated with intravitreal dexamethasone needed only one implant until month 12, while no serious adverse events were noticed in any group. Conclusions: Intravitreal dexamethasone implant was found to be effective and safe for the treatment of macular edema after PPV for ERM removal.

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Section: Discussionsupporting

confidence: 92%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Treatment of Macular Edema after Pars Plana Vitrectomy for Idiopathic Epiretinal Membrane Using Intravitreal Dexamethasone Implant: Long-Term Outcomes

et al. 2019

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“…In the same study, the macular thickness was observed to increase between 10 and 16 weeks, and the dexamethasone implant was reapplied to 12 of 25 eyes [ 33 ]. In another study by Hattenbach et al, the medical records of 37 patients (39 eyes) who had been treated with intravitreal DEX implant for postoperative persistent cystoid macular edema following vitrectomy and peeling of idiopathic epiretinal membranes were retrospectively reviewed [ 39 ]. And they reported that 17 of 39 eyes (43.6%) necessitated minimum 1 repeat injection of DEX implant.…”

Section: Discussionmentioning

confidence: 99%

Comparison of the Effect of Intravitreal Dexamethasone Implant in Vitrectomized and Nonvitrectomized Eyes for the Treatment of Diabetic Macular Edema

Çevik

Yılmaz

Çevik

et al. 2018

Journal of Ophthalmology

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Purpose To compare the effectiveness of sustained-release dexamethasone (DEX) intravitreal implant in nonvitrectomized eyes and vitrectomized eyes with diabetic macular edema (DME). Methods A retrospective review of the medical records of 40 eyes of 30 consecutive patients with diabetic macular edema who underwent intravitreal DEX implant injection. Patients were divided into 2 subgroups: 31 eyes that were nonvitrectomized (group 1) and 9 eyes that had previously undergone standard pars plana vitrectomy (group 2). The main outcome measures were BCVA and foveal thickness (FT). Results A significant improvement was seen in BCVA in both group 1 and group 2 at the 1st, 2nd, and 6th months after treatment with DEX implant (p < 0.05). In group 1, a significant reduction in FT was observed at the 1st, 2nd, and 6th months (p < 0.05). In group 2, a significant reduction in FT was seen at the 1st and 2nd months (p < 0.05), but the reduction rate at the 6th month after the injection was not statistically significant (p = 0.06). Conclusion DEX implant is effective for the treatment of diabetic macular edema, and the effectiveness of the drug is similar in vitrectomized and nonvitrectomized eyes.

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“…e efficacy of DEX in the treatment of PCME after vitrectomy for ERM has been reported in several case studies [27][28][29] and in two large retrospective studies [30][31][32], whereas only two studies have evaluated DEX after vitrectomy for RRD repair [31,33]. However, no study has as yet evaluated any visual or morphological OCT biomarkers for their predictive value in the treatment of PCME in vitrectomized eyes.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of Functional Outcomes and OCT-Biomarkers after Intravitreal Dexamethasone Implant for Postoperative Cystoid Macular Edema in Vitrectomized Eyes

Freissinger

Vounotrypidis

Wolf

et al. 2020

Journal of Ophthalmology

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Purpose. To evaluate the efficacy of dexamethasone implant (DEX) for the treatment of postoperative cystoid macular edema (PCME) in vitrectomized eyes and to investigate visual and morphological OCT predictive factors. Methods. In this retrospective study, eyes with PCME after vitrectomy were treated with at least one DEX injection and were observed over 12 months. Indications for surgery were epiretinal membrane (ERM) or rhegmatogenous retinal detachment (RRD) without macular involvement. Prior treatments, if any, were noted. Best corrected visual acuity (BCVA), central foveal thickness (CFT), and OCT morphology including the presence of intraretinal cysts/fluid or subretinal fluid (IRF/SRF) and ellipsoid zone (EZ) continuity were evaluated. Correlations between OCT measures and visual outcomes were analyzed by the generalized estimating equations procedure. Results. Forty-six eyes with ERM and 15 eyes with RRD were enrolled. The ERM group was more likely to gain BCVA than RRD (odds ratio (OR), 1.168; 95% confidence interval (CI), 1.003–1.360; p=0.046). The absence of SRF (OR, 0.860; 95% CI, 0.743–0.995; p=0.043) was predictive of worse BCVA, whereas the integrity of EZ (OR, 1.094; 95% CI, 0.951–1.257; p=0.209) or naïve status (OR, 0.946; 95% CI, 0.871–1.137, p=0.853) was not. Eyes with a worse baseline BCVA were more likely to gain >1 line after 12 months (OR, 1.485; 95% CI, 1.171–1.884; p=0.001). Conclusion. The efficacy of the treatment of PCME in vitrectomized eyes seems to be affected by baseline BCVA, the absence of SRF, and the indication for surgery. Naïve status appears not to play any significant role in the prediction of BCVA. This trial is registered with DRKS00018955.

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Intravitreal Sustained-Release Steroid Implants for the Treatment of Macular Edema following Surgical Removal of Epiretinal Membranes

Cited by 31 publications

References 22 publications

Treatment of Macular Edema after Pars Plana Vitrectomy for Idiopathic Epiretinal Membrane Using Intravitreal Dexamethasone Implant: Long-Term Outcomes

Treatment of Macular Edema after Pars Plana Vitrectomy for Idiopathic Epiretinal Membrane Using Intravitreal Dexamethasone Implant: Long-Term Outcomes

Comparison of the Effect of Intravitreal Dexamethasone Implant in Vitrectomized and Nonvitrectomized Eyes for the Treatment of Diabetic Macular Edema

Evaluation of Functional Outcomes and OCT-Biomarkers after Intravitreal Dexamethasone Implant for Postoperative Cystoid Macular Edema in Vitrectomized Eyes

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