Purpose
To assess the early morphological and functional response to therapy with dexamethasone erodible implant on macular edema secondary to retinal vein occlusion.
Methods
Patients with visual impairment due to macular edema secondary to retinal vein occlusion were prospectively included. Indication for treatment was an angiographically evident branch or central retinal vein occlusion with presence of central-involving macular edema on spectral domain optical coherence tomography (SD-OCT). Patients received treatment with intravitreal erodible dexamethasone implant and were scheduled for follow-up examinations at 1, 2, 3, 7, 14, 21, and 28 days after treatment. Best-corrected visual acuity (BCVA, LogMAR), SD-OCT, and Goldmann applanation tonometry were performed at baseline and at follow-up visits. The primary efficacy outcome was change in central retinal thickness (CRT). Secondary outcomes include change in BCVA and intraocular pressure. The incidence of ocular and non-ocular adverse events was recorded. Repeated-measures ANOVAs, with Greenhouse-Geisser correction and a significance level of 5%, were conducted to assess whether there were differences between average values. Serial comparisons of pretreatment and post-treatment outcomes were performed with Dunnett multiple comparisons tests.
Results
The study included 16 consecutive eyes of 14 patients. Results indicate that CRT changed significantly (p<0.0001). Post test between baseline and follow-up values demonstrated that the reduction in CRT was significant at each follow-up visit. Mean CRT change was -225 μm, -288 μm, -332, -301 μm, -308 μm, -340 μm, -317 μm at 1, 2, 3, 7, 14, 21, and 28 days, respectively. Visual acuity improved significantly (p<0.01). Mean BCVA change was +11 ETDRS letters at the end of the follow-up. Non-significant changes were noted with regards to intraocular pressure values. No significant adverse events were recorded during the follow up.
Conclusions
The intravitreal administration of erodible dexamethasone implant produces an extremely rapid CRT improvement in patients with macular edema due to retinal vein occlusion. Most of the reduction of retinal thickness can be recorded as soon as one day after treatment.
Keywords: 505 edema •
585 macula/fovea •
688 retina