Abstract
Purpose:
To investigate changes in macular sensitivity after intravitreal dexamethasone implant for macular edema (ME) secondary to retinal vein occlusion (RVO).
Methods:
19 treatment-naive patients with RVO ME were enrolled in this prospective uncontrolled study.Patients were treated with intravitreal Ozurdex and followed up at 1 month 3, 4, 5 and 6 months for the evaluation of morphological and functional outcomes, by means of BCVA, microperimetry, and spectral-domain optical coherence tomography (SD-OCT).
Results:
19 eyes of 19 patients were included for analysis.At 1 month (19 eyes) mean BCVA, retinal sensitivity, and central macular thickness (CMT) improved from 0.50±0.34 LogMAR, 10.51±4.31 dB, and 762±259 μm to 0.38±0.34 LogMAR, 12.28±5.06 dB, and 385±191 μm, respectively.At 3 months (19 eyes) improvement of mean BCVA, retinal sensitivity, and CMT decreased (0.54±0.36 LogMAR, 11.62±5.05 dB, and 518±251 μm, respectively); at this time point, 2 eyes were retreated with intravitreal dexamethasone.At 4 months (17 eyes) mean BCVA, retinal sensitivity and CMT were 0.68±0.45 LogMAR, 8.64±4.45dB, and 671±239 μm respectively; at this time point, 4 eyes were retreated.At 5 months (13 eyes) mean BCVA, retinal sensitivity, and CMT were 0.83 ±0.42 LogMAR, 8.1±3.4 dB, and 670±218 μm respectively; at this time point, 6 eyes were retreated. Interestingly 7 eyes did not underwent retreatment up to 6 months from first intravitreal dexamethasone; in these eyes mean BCVA, retinal sensitivity, and CMT changed from 0.46±0.29 LogMAR, 12.27±3.52 dB, and 715±219 μm (baseline, versus 0.53±0.37LogMAR, 9.48±4.53dB, and 790±286μm, in eyes that underwent retreatment <6 months), to 0.41±0.45 LogMAR, 11.33±5.32 dB, and 547±216 μm (6 months), respectively.At 6 months, 5 eyes were retreated.1 month after retreatment with intravitreal dexamethasone (12 eyes) mean BCVA, retinal sensitivity, and CMT improved from last pre-retreatment visit (from 0.93±0.77 LogMAR, 8.42±3.98 dB, and 711±172 μm to 0.77±0.46LogMAR [p=0.03], 10.63 ±4.63 dB [p=0.04], and 497±262 μm [p=0.01], respectively).
Conclusions:
In eyes with ME secondary to RVO,microperimetry shows improvement in macular sensitivity 1 month after treatment/retreatment with intravitreal dexamethasone.Eyes that underwent retreatment <6 months showed a worse baseline BCVA and macular sensitivity compared with eyes not requiring retreatment up to 6 months.