Rebound Effect After Intravitreal Dexamathasone Implant For The Treatment Of Macular Edema Secondary To Central Retinal Vein Occlusion

Abstract

Purpose: : To report on the rebound effect of macular edema (ME) following dexamathasone implant for the treatment of non-ischemic central retinal vein occlusion (CRVO).

Methods: : Twenty-one patients affected by ME secondary to CRO underwent intravitreal implant of dexamethasone (700micrograms) on compassionate use program. The patients were followed up monthly. ETDRS best corrected visual acuity (BCVA), central foveal thickness (CFT) on OCT, and intraocular pressure were monthly registered.

Results: : BCVA improved in all the cases as well as CRT at months 1, and 2. Interestingly, CFT turned out to be double with respect to the baseline value at the month-3 examination visit in 1 case, and another 2 cases at month-4 examination visit. Visual acuity reduced accordingly to the worsened CFT values. Additional treatment with intravitreal dexamethasone implant allowed both visual acuity recovery, and CFT reduction.

Conclusions: : Rebound effect can develop after intravitreal dexamethasone implant for the treatment of ME related to CRVO. Rebound effect does not affect functional or anatomical recovery when re-treatment is provided. Re-treatment rate with intravitreal desamethasone implant should be customized according to the patient’s response.

Keywords: vascular occlusion/vascular occlusive disease • edema • corticosteroids