The Effect of Age and Initial Central Retinal Thickness on Earlier Need of Repeat Ozurdex Treatment for Macular Edema Due to Retinal Vein Occlusion: A Retrospective Case Series

Lin, Chun-Ju; Chen, Huansheng; Su, Cheng-Wen; Tien, Peng-Tai; Lin, Jane-Ming; Kuo, Chung-Yuan; Lai, Chun-Ting; Tsai, Yi–Yu

doi:10.1089/jop.2017.0070

Cited by 7 publications

(16 citation statements)

References 35 publications

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“…Moreover, the safety profile of Ozurdex for BRVO-ME demonstrated in this study was favourable and consistent with those reported in previous studies [24][25][26]. Considering the peak level, in the present study, only 24.1% of the patients ever had an IOP > 25 mmHg, and increases in IOP were generally controlled with topical medications.…”

Section: Discussionsupporting

confidence: 92%

“…Previous studies had reported that older age and greater initial CRT constitute risks for Ozurdex retreatment among some populations. For example, in a previous study conducted in Taiwan of both BRVO and central RVO patients, Lin et al found that older age and greater initial CRT are risk factors for multiple injection in such patients [26]. Similarly, the COBALT study conducted in Korea also found that older age and higher initial CRT were indicators for reinjection of Ozurdex in BRVO-ME cases.…”

Section: Discussionmentioning

confidence: 95%

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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: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 95%

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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“…Also, some studies whose final outcome was not BCVA and CRT, the results were not reported, and patients had already received other treatments were also excluded. Finally, seven eligible studies including 393 eyes were used in the present meta-analysis [7][8][9][10][11][12]. The flow chart for the study selection process is shown in Figure 1.…”

Section: Search Resultsmentioning

confidence: 99%

“…Further, the CRT was disturbed by many factors, such as individual difference, measurement error, individual sensitivity to medication, and actual dosage of medication administered. The heterogeneity of mean change in the CRT after 12 months was caused by the studies of Chun-Ju Lin et al [8] and Mariacristina et al [9]. In these two studies, some patients were injected more than one time.…”

Section: Discussionmentioning

confidence: 99%

Safety and effectiveness of intravitreal injection of dexamethasone for macular edema secondary to retinal vein occlusion: a meta-analysis

He¹,

Gao²,

Dan³

et al. 2020

Preprint

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Background: This meta-analysis aimed to investigate the efficacy and safety of intravitreal injection of dexamethasone (DEX) in treating macular edema secondary to retinal vein occlusion. Method: PubMed, Embase-clinical key, clinicaltrials.gov, Web of Science, and SinoMed were searched to compare the application of DEX implant in patients with retinal vein occlusion secondary macular edema (RVO-ME). The central retinal thickness, best-corrected visual acuity (BCVA), postoperative intraocular pressure, and postoperative cataract were extracted. RevMan 5.3 was used to analyze and evaluate the data. Results: This study was based on six randomized trials. A total of 393 eyes were studied. DEX implant could effectively reduce macular edema caused by retinal vein occlusion. After 6 months, the drug could significantly improve the patients’ BCVA [95% confidence interval (CI), 9.669–21.649, P = 21.649]. At the same time, it also could significantly reduce the patients’ central retinal thickness (95% CI: 274.965–142.236, P = 0.0000). DEX implant could increase the intraocular pressure in some patients and greatly increase the risk of cataracts. Conclusions: DEX implant can effectively improve the BCVA of patients with RVO-ME, reduce the central thickness of the retina, and reduce the number of injections for a relatively long time. Therefore, intravitreal injection of DEX can be used as an effective method for treating RVO-ME.

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“…Younger eyes have a better visual response to the DEX treatment which is not surprising as multiple previous studies have demonstrated similar diminishment in response in older eyes. 26,27 Likely a contributing factor for the diminished response in older populations is the chronicity of their illness making it more recalcitrant to therapy.…”

Section: Uveitismentioning

confidence: 99%

<p>Initial Ten Years of Experience with the Intravitreal Dexamethasone Implant: A Retrospective Chart Review</p>

Wallsh¹,

Luths²,

Kil³

et al. 2020

OPTH

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Purpose: To evaluate the initial ten years of results from the intravitreal dexamethasone implant (DEX) in patients treated for retinal vein occlusion (RVO), diabetic macular edema (DME) or uveitis. Methods: Retrospective chart review of patients receiving DEX since its FDA approval. Best-corrected visual acuity (BCVA), central macular thickness (CMT) on optical coherence tomography, intraocular pressure and cataract status were collected. Baseline data were collected from the initial DEX and post-treatment data at the visit at least four weeks after the last DEX. Results: In total, 315 eyes received 1216 DEX over 63.9±4.6 weeks. In the branch RVO (n=90), central RVO (n=59) and DME (n=62) cohorts, BCVA improved significantly (p<0.05). The uveitis (n=154) cohort did not have a significant change in BCVA, 0.62 ±0.04 to 0.61±0.04 logMAR (p=0.34). Younger patients, vitrectomized eyes, and eyes without a history of glaucoma were associated with significantly better BCVA outcomes in the uveitis cohort (p<0.05). Overall, CMT decreased significantly from 376.6±6.8 to 322.7±5.0 µm (p<0.05). Intraocular pressure increased significantly (p<0.001) and the percentage of patients requiring anti-glaucoma medications increased from 33.0% to 67.6%. Of phakic eyes, 58.8% (n=63) had cataract progression or underwent surgery with those who underwent surgery experiencing a significant improvement in BCVA (p<0.05). Conclusion: Repeated DEX over extended follow-up offers significant anatomic benefits to all cohorts. Visual benefits are only seen in RVO, DME and select uveitis demographics.

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The Effect of Age and Initial Central Retinal Thickness on Earlier Need of Repeat Ozurdex Treatment for Macular Edema Due to Retinal Vein Occlusion: A Retrospective Case Series

Abstract: Patients receiving as-needed schedule of dexamethasone intravitreal implant had significant peak CRT and BCVA improvement. Age older than 55 years and initial CRT more than 400 μm were significant risk factors associated with repeated dexamethasone intravitreal implant treatment.

Cited by 7 publications

References 35 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

Safety and effectiveness of intravitreal injection of dexamethasone for macular edema secondary to retinal vein occlusion: a meta-analysis

<p>Initial Ten Years of Experience with the Intravitreal Dexamethasone Implant: A Retrospective Chart Review</p>

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