Real-life medium term follow-up data for intravitreal dexamethasone implant in retinal vein occlusion

Abstract

Macular edema (ME) is the most frequent vision threatening consequence after retinal vein occlusion (RVO). In this study, we evaluate the effect of dexamethasone intravitreal implants (DII, Ozurdex) in a real-life cohort of 99 patients with ME due to RVO. All patients who received DII for ME following RVO between 2011 and 2016 at the University Eye Hospital Freiburg, Germany and who had fully accessible electronic medical records were eligible for this study. Most of the patients included in this study were not treatment-naïve: 61 eyes had received prior anti-VEGF drugs, 6 eyes had received intravitreal corticosteroids (triamcinolone) and 15 had been treated with both; 17 eyes were treatment-naïve. Mean follow-up was 312 ± 310 days. Mean visual acuity (VA) was maintained throughout the observation period (mean VA at baseline: 66.7 ± 23.5 letters; at last observation 64.9 ± 28.3). Central retinal thickness (CRT) decreased from 526 ± 179 µm at baseline to 431 ± 199 µm. Mean intraocular pressure (IOP) increased from 14.4 ± 3.1 mmHg at baseline to 17.1 ± 6.3 mmHg. Cataract surgery was performed in 22% of phakic eyes. DII was used as second-line treatment in the majority of cases in this cohort. The fact that mean VA remained unchanged while mean CRT decreased illustrates that morphologic improvement does not always translate into functional gain. Mean IOP was maintained within normal limits and cataract formation was as expected in this age group.

Efficacy and safety of the dexamethasone implant in vitrectomized and nonvitrectomized eyes with diabetic macular edema: A systematic review and meta-analysis

“…The dexamethasone (DEX) intravitreal implant (Ozurdex; Allergan, Irvine Inc., CA, United States), a biodegradable device designed to slowly release DEX for up to 6 months after injection, has been approved for the management of DME and ME following retinal vein occlusion and noninfectious posterior uveitis ( Lowder et al, 2011 ; Boyer et al, 2014 ; Wecker et al, 2021 ). Its efficacy and safety have been well demonstrated not only for treatment-naive DME ( Boyer et al, 2014 ; Mathis et al, 2020 ) but also for persistent DME refractory to intravitreal anti-VEGF medications ( Zhioua et al, 2015 ; Shah et al, 2016 ; Yuan et al, 2022 ).…”