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Saeed Talab Alshahrani, J Fernando Arevalo; Intravitreal Dexamethasone Implant for the Treatment of Macular Edema in Retinal Vascular Diseases in Saudi Arabia. Invest. Ophthalmol. Vis. Sci. 2014;55(13):1777.
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© ARVO (1962-2015); The Authors (2016-present)
To study the efficacy and safety of an intravitreal implant (sustained release of dexamethasone, Ozurdex®) for the treatment of macular edema in retinal vascular diseases in Saudi Arabia
Retrospective non-consecutive study of patients with macular edema secondary to central retinal vein occlusion, branch retinal vein occlusion and diabetic retinopathy treated with a dexamethasone implant of 0.7 mg. Follow-up visits were performed at 1 month, 3 months and 6 months. Early Treatment Diabetic Retinopathy Study (ETDRS) best corrected visual acuity, Goldmann tonometry and macular thickness on spectral domain-optical coherence tomography (SD-OCT) were registered.
Fourteen eyes with macular edema of 14 patients were included; 2 with branch retinal vein occlusion, 7 with central retinal vein occlusion, and 5 with diabetic macular edema. Nine (64.2%) eyes improved best-corrected visual acuity (BCVA). Four (28.5%) eyes achieved 3 lines or more of BCVA gain, 5 (35.7%) eyes showed improvement of BCVA of less than 3 lines (1 to 2 lines), and 5 eyes (35.7%) remained stable at 1 month. Central macular thickness (CMT) at base line (BL) had a mean of 637 µm (range: 310 to 950 µm). All cases showed anatomical response at 1 month with a mean CMT of 272 µm (range: 140 to 460 µm). In 9 (64.2%) eyes the macular edema resolved at month 1. Eleven (78.5%) eyes showed recurrence of macular edema at month 3 with a mean CMT of 493 µm (range: 157 to 1430 µm). At 6 months the CMT had a mean of 522 µm (range: 94 to 1083 µm). All these differences were statistically significant when compared to BL (p < 0.05). High intraocular pressure (> 21 mm Hg) was observed after implantation in 5 (35.7%) eyes but it was controlled with topical anti-glaucoma medications. No other serious side effects were observed.
Our study showed the efficacy and safety of an intravitreal dexamethasone implant in the treatment of macular edema due to retinal vascular diseases. Functional and anatomical efficacy was achieved at month 1. However, the effect lasted less than 3 months in most eyes, which is shorter than previously published.
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