June 2013
Volume 54, Issue 15
Free
ARVO Annual Meeting Abstract  |   June 2013
Increased Healthcare Cost Related To Adding Dexamethasone Implant (Ozurdex®) To Bevacizumab (Avastin®) Monotherapy In Patients With Cystoid Macular Edema (CME) Due To Retinal Vein Occlusion (RVO) May Be Balanced By Less Frequent Follow-Up
Author Affiliations & Notes
  • Omar Saleh
    University of Louisville, Louisville, KY
  • James Heroman
    University of Louisville, Louisville, KY
  • Shlomit Schaal
    University of Louisville, Louisville, KY
Investigative Ophthalmology & Visual Science June 2013, Vol.54, 4932. doi:
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      Omar Saleh, James Heroman, Shlomit Schaal; Increased Healthcare Cost Related To Adding Dexamethasone Implant (Ozurdex®) To Bevacizumab (Avastin®) Monotherapy In Patients With Cystoid Macular Edema (CME) Due To Retinal Vein Occlusion (RVO) May Be Balanced By Less Frequent Follow-Up. Invest. Ophthalmol. Vis. Sci. 2013;54(15):4932.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose: To investigate the effect of adding intravitreal Ozurdex therapy to Avastin monotherapy for the treatment of CME due to branch RVO (BRVO) or central RVO (CRVO) on functional outcome, anatomical outcome, frequency of injections, and cost

Methods: 35 patients (18 BRVO and 17 CRVO) treated initially with Avastin and later on with Ozurdex were included. Best corrected visual acuity (BCVA) and central macular thichness (CMT) on OCT were documented every 6 weeks for up to 228 weeks. Frequency of injections and cost of therapy were compared before and after Ozurdex was injected

Results: Throughout 87 ± 60 (20-228) weeks of follow-up, BRVO patients received a mean of 1.6 ± 0.8 Ozurdex injections (39 ± 24% of all injections) and CRVO patients received 1.8 ± 1 injections (37 ± 19% of all injections). In BRVO, an Ozurdex implant was received every 28 ± 14 weeks starting 30 ± 28 weeks after Avastin therapy and in CRVO an Ozurdex implant was received every 26 ± 12 weeks starting 37 ± 35 weeks after Avastin therapy. After Ozurdex was added to Avastin therapy, the mean frequency of any intravitreal injection in BRVO decreased from injection every 10 ± 4 weeks to every 21 ± 15 weeks (p<0.01) and from injection every 11 ± 6 weeks to every 19 ± 17 weeks in CRVO (p>0.2). The mean number of fluid-free treatment-free visits increased from 1.3 ± 1.7 to 4.6 ± 3.7 visits in BRVO (p<0.01) and from 2.6 ± 3.4 to 5 ± 4.4 visits in CRVO (p>0.05). Initiation of treatment with Ozurdex did not influence BCVA, which remained at 20/68 ± 20/76 in BRVO and at 20/105 ± 20/58 in CRVO, but decreased mean CMT from 399 ± 88 to 344 ± 96 µ in BRVO (p<0.01) and from 478 ± 86 to 348 ± 114 µ in CRVO (p<0.01). Mean monthly cost of therapy increased from 293 ± 60 $ to 408 ± 111 $ in BRVO (p<0.01) and from 253 ± 114 $ to 436 ± 151 $ in CRVO (p<0.01)

Conclusions: The addition of Ozurdex to Avastin therapy in the treatment of CME due to RVO reduced the overall frequency of intravitreal injections needed to control the disease, reduced CMT but did not affect BCVA, and increased the cost of treatment. Decreasing the frequency of follow-up for Ozurdex-injected patients from every 6 weeks to every 10 weeks may compensate for the increased healthcare cost

Keywords: 749 vascular occlusion/vascular occlusive disease • 688 retina • 561 injection  
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