Purpose:
to evaluate the effectiveness and safety of OZURDEX®(dexamethasone intravitreal implant) 0.7mg in patients with macular edema (ME) due to retinal vein occlusion.
Methods:
this 6-month non randomized case series study collected 15patients with ME due to branch retinal vein occlusion (7 eyes) and central retinal vein occlusion (8 eyes) (BRVO and CRVO respectively). Ophthalmic examination, best-corrected visual acuity (BCVA), intraocular pressure (IOP), fluorescein angiography and optical coherence tomography (OCT), at baseline and each follow-up visit were carried out. Outcome measures included BCVA, central retinal thickness (CRT) by OCT and safety. Mean change of visual acuity (VA), OCT, and IOP was assessed during the follow-up (6 months), using repeated measures analysis of variance, after testing for normality. A linear regression model was also used to evaluate the relationship between OCT and VA, as measured after 6 months of follow-up.
Results:
at baseline all eyes (15) with occlusive ME received DEX Implant700μg. Among these patients all had retinal vein occlusion > 3 months (mean 12.8 ± 7.5). VA, IOP, and OCT at baseline and during the follow up period are summarized in Figure 1. Mean change of VA between baseline and each time point follow-up was not statistically significant (p = 0.2464) with only OCT measurements that showed statistically significant differences with a repeated-measures ANOVA test (p<0.001) at 6 months follow-up. Statistical analysis showed some evidence of benefit on CRT at earlier time points. The peak effects were seen at two months, and there was substantial drop-off between two and three months. Increases in IOP were similar and generally transient following each DEX Implant (p = 0.0929). Simple linear regression analysis showed no statistically significant negative relationship between OCT and VA measured after 6 months (slope -0.00067, 95% CI: -0.0014 - 0.0000488 ).
Conclusions:
in patients with ME due to BRVO and CRVO, DEX Implant 0.7 mg produced substantial improvements in CRT, without, however, improving VA significantly..
Keywords: retina • vascular occlusion/vascular occlusive disease • edema