April 2014
Volume 55, Issue 13
ARVO Annual Meeting Abstract  |   April 2014
Safety and Efficacy of Two or More Dexamethasone Intravitreal Implants in Treatment-Naïve Patients with Macular Edema Due to Retinal Vein Occlusion
Author Affiliations & Notes
  • Michael Singer
    Med Ctr Ophthalmology Assoc, San Antonio, TX
  • Antonio Capone
    Associated Retinal Consultants, Novi, MI
    Oakland University, William Beaumont Hospital School of Medicine, Rochester, MI
  • Pravin U Dugel
    Retinal Consultants of Arizona, Phoenix, AZ
  • Richard F Dreyer
    Retina Northwest PC, Portland, OR
  • David G Dodwell
    Illinois Retina Center, Springfield, IL
  • Daniel B Roth
    Retina-Vitreous Center, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ
  • Rui Shi
    Allergan, Inc., Irvine, CA
  • John G Walt
    Allergan, Inc., Irvine, CA
  • Lanita C Scott
    Allergan, Inc., Irvine, CA
  • David A Hollander
    Allergan, Inc., Irvine, CA
  • Footnotes
    Commercial Relationships Michael Singer, Allergan, Inc. (C), Allergan, Inc. (F), Allergan, Inc. (R); Antonio Capone, Allergan, Inc. (C), Allergan, Inc. (F), Allergan, Inc. (R); Pravin Dugel, Allergan, Inc. (C); Richard Dreyer, Allergan, Inc. (F); David Dodwell, Allergan, Inc. (C); Daniel Roth, Allergan, Inc. (C), Allergan, Inc. (R); Rui Shi, Allergan, Inc. (E); John Walt, Allergan, Inc. (E); Lanita Scott, Allergan, Inc. (E); David Hollander, Allergan, Inc. (E)
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science April 2014, Vol.55, 1797. doi:
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      Michael Singer, Antonio Capone, Pravin U Dugel, Richard F Dreyer, David G Dodwell, Daniel B Roth, Rui Shi, John G Walt, Lanita C Scott, David A Hollander; Safety and Efficacy of Two or More Dexamethasone Intravitreal Implants in Treatment-Naïve Patients with Macular Edema Due to Retinal Vein Occlusion. Invest. Ophthalmol. Vis. Sci. 2014;55(13):1797.

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

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Purpose: To evaluate the safety and efficacy of treatment with ≥2 dexamethasone intravitreal implants (DEX implants) in treatment-naïve patients with macular edema due to branch or central retinal vein occlusion (BRVO, CRVO).

Methods: A multicenter, retrospective, open-label chart review study (SHASTA study) evaluated the safety and efficacy of DEX implant in 289 patients with BRVO or CRVO who were treated with ≥2 DEX implants and followed for 3-6 months after the last implant. Adjunctive treatments for RVO were permitted. Efficacy outcome measures included best-corrected visual acuity (BCVA) and central retinal thickness (CRT) by optical coherence tomography. Subgroup analysis evaluated results in treatment-naïve patients who had received no treatment for complications of RVO prior to their first DEX implant.

Results: Thirty-nine patients were treatment-naïve at the time of their first DEX implant (18 BRVO, 21 CRVO). Prior to DEX implant treatment in treatment-naïve patients, mean duration of macular edema was 4.9 months, mean CRT was 550 µm, and mean BCVA was 8.5 lines (20/125 Snellen). Treatment-naïve patients received a mean of 2.9 DEX implants during the study period. DEX implant was used as monotherapy in 12 (30.8%) patients and combined with other RVO therapy in 27 (69.2%) patients. After the first through sixth DEX implant injections, mean change in BCVA from baseline ranged from +3.0 to +8.0 lines, and mean change in CRT from baseline ranged from -241 to -459 µm. BCVA improvement was seen both in BRVO and CRVO. Overall, 83.8% of patients gained at least 2 lines in BCVA, 70.3% gained at least 3 lines in BCVA, and 56.4% achieved CRT ≤250 µm during the study period. The most common adverse event was increased intraocular pressure. Fifteen treatment-naïve patients had an IOP measurement ≥25 mm Hg; no treatment-naïve patients required laser or incisional glaucoma surgery during the study period.

Conclusions: Use of ≥2 DEX implants either as monotherapy or in combination with other RVO treatments is safe and effective in reducing CRT and improving BCVA in treatment-naïve patients with BRVO or CRVO.

Keywords: 749 vascular occlusion/vascular occlusive disease • 487 corticosteroids • 748 vascular endothelial growth factor  

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