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Valerie Krivosic, Sylvain Michee, Benedicte Dupas, Sebastien Bruno, Alain Gaudric, Pascale Massin, Ramin Tadayoni; Dexamethasone Intravitreal Implants For Retinal Vein Occlusion In A Clinical Setting. Invest. Ophthalmol. Vis. Sci. 2012;53(14):924.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate efficacy and side effects of dexamethasone intravitreal implant in a clinical setting.
Retrospective study including consecutive patients treated for retinal vein occlusion (RVO) with a dexamethasone intravitreal implant (ozurdex ®) in our department and with a follow-up > 2 months. 41 patients were included. Indication was in all cases cystic macular edema associated with 21 cases of central retinal vein occlusion and 20 cases of branch retinal vein occlusion. Median age was 66.37 yo (range: 29 to 90). Among patients, 61.9% were male and 38.1% were female. The follow up was 2-9 months. Evaluation criteria were: visual acuity before and 2 months after injection, side effects during follow-up, anatomical improvement on OCT, numbers of injections, and time between injections.
The Median visual acuity improved from 0.25 (0.05 to 0.5) before injection to 0.38 (0.05 to 0.8) at the end of the follow up. Macular edema improved (OCT mapping) in 80.55% of eyes. Among the 28 patients who had a follow-up > 6 months (range: 6-9 months) 10 patients (35.71%) had a recurrence of their edema needing a second injection. The delay between the 2 injections in these 10 patients was 5.45 months (3 to 8 months). Side effects were reported in 44.44% of patients: 36.11% presented an hypertonia needing medication prescription, among phakic patients 12.9% presented an early cataract. One patient had a retinal detachment (2.44%).
In this study, dexamethasone intravitreal implant improved vision and decreased edema due to retinal vein occlusions. Two third (2/3) of patients followed-up > 6 months did not need a second injection during their follow-up (6 to 9 months). Side effects were above all ocular hypertonia in 36.11% of patients but also cataract. In this series one patient presented a retinal detachment.In our clinical setting dexamethasone intravitreal implant was effective for the treatment for macular edema due to RVO and the main complications were hypertonia in nearly 1/3 of patients and cataract.
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