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Ahmed A I Sallam, Irene Stratton, UK Dexamethasone Implant for Retinal Vein Occlusion Study Group; United Kingdom national database study of intravitreal dexamethasone implant (Ozurdex®) for retinal vein occlusion related macular edema: visual outcome and safety of treatment. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):5805.
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© ARVO (1962-2015); The Authors (2016-present)
Intravitreal dexamethasone implant (Ozurdex) has been approved in the UK in 2011 for treatmet of macular edema due to central retinal vein occlusion (CRVO) or branch retinal vein occlsion (BRVO). Ozurdex for this indication was evaluated in the GENEVA Trial. However, clinical trials are different from real-world clinical setting.<br /> <br /> The purpose of this work was to analysze visual outcomes and common complications for patients treated with Ozurdex for macular edema due to retinal vein occlusion in the UK.
Prospectively collected anonymized data within an electronic medical record system (Medisoft®) from 16 NHS centres across the UK were retrospectively extracted. Data analysed was restricted to first treated eye per patient. Pre-treatment characteristics assessed included: patients’ age, gender, ethnicity and co-existing ocular pathology. Data on visual outcome, IOP and cataract surgery of first and repeat Ozurdex treatment were analysed.
We analyzed data of 1550 eyes that received at least 1 Ozurdex injectio for either CRVO (44.4%) or BRVO (55.6%) from 16 centres,<br /> Of these eyes, 614 (40%) received >1 Ozurdex injection. Mean age of patients at the time of first injection episode was 73 years and 50% of patients were males. Signficant visual acuity improvement was seen after each Ozurdex injection with 37%, 33% and 35% of eyes achieving ≥15 ETDRS letters after the first, second and third injection, respectively. Of all treated eyes, 6% had ocular hypertension or controlled glaucoma before treatment. Intraocular pressure rise of ≥10 mmHg was seen in 13% (265 eyes) with 6% of eyes having IOP ≥ 25 mmHg. Peak time for addition of glaucoma drops (new or extra prescription) ranged from 2 to 3 months after ozurdex treartment and 4 eyes required incisonal glaucoma surgery. Cataract surgery in phakic eyes was undertaken in 8.7% (100/1143).
Retinal vein occlusion patients treated with Ozurdex for retinal vein occlusion had improved visual acuity despite increased risk of IOP rise and increased frequency of cataract surgery. Though not evaluated in the GENEVA trial, Ozurdex is used in patients with glaucoma/ocular hypertension in the clinical setting.
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