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Stéphanie Hayek, Margaux Guillard, Antoine P Brezin, Dominique Monnet; The intravitreal dexamethasone implant treatment of patients with cystoid macular edema (Ozurdex®) from Birdshot retinochoroidopathy in a tertiary center.. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):3120.
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© ARVO (1962-2015); The Authors (2016-present)
To analyze the efficacy of dexamethasone intravitreal implant 0.7 mg (Ozurdex®) in the treatment of patients with cystoid macular edema in the context of Birdshot retinochoroidopathy.
A retrospective charts review of patients with cystoid macular edema (ME) secondary to birdshot retinochoroidopathy treated with dexamethasone intravitreal implant in a tertiary referral center. The main outcome measures were the reduction in central macular thickness (CMT) and improvement in best corrected visual acuity (BCVA) from baseline to study end. CMT was measured by spectral domain OCT. The following data were recorded : BCVA, CMT, hyalitis, retinal vasculitis on fluorescein angiogram, presence of cataract and ocular hypertonia at baseline and 1 month, 3 months, 6 months, one year after intravitreal implantation.
Twenty six eyes of 19 patients were included. 15 eyes were injected once, the others had multiple injections. In patient with only one injection, increase of BCVA was significant at 3 months post-implant with a mean increase of 0,25 ± 0,30 logMAR(p=0,0001). Reduction in central retinal thickness was significant in patients with cystoid macular edema at 1 month and 3 month post-implant with a mean decrease of respectively 108,87 ± 129,75 micron (p=0,0001) and 148,57 ± 196,65 micron (p=0,0001). In patients with more than one injection, reduction in central retinal thickness was significant 1 month after the first implantation with a mean decrease of 198,73 ± 209,67 micron (p=0,0049). Increase of BCVA was significant at 1 month with a mean increase of 0.16 ± 0.16 logMAR à (p= 0,0039) and 3 month with a mean increase of 0.18 ± 0.13 logMAR (p=0,002). Intraocular inflammation was present in 65.4% at baseline, and then 26,9%, 16%, 14.3% and 10.5% of patients at 1 month, 3 months, 6 months and 1 year after receiving the implant, respectively. Adverse events included increased intraocular pressure (23.1%) which required medical treatment only (no surgical procedures were needed) and cataract formation (50%).
The data suggest that intravitreal dexamethasone implant 0,7mg (Ozurdex) is an important help to control macular edema in patient with birdshot retinochoroidopathy. Moreover, our study confirm the association of this treatment with ocular hypertension requiring medical treatment and cataract formation.
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