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Vincent Fortoul, Philippe Denis, Laurent Kodjikian; Clinical And SD-OCT Pattern Of Retinal Venous Occlusion With Cystoid Macular Edema Treated With Ozurdex. Invest. Ophthalmol. Vis. Sci. 2012;53(14):969.
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© ARVO (1962-2015); The Authors (2016-present)
To report our experience with sustained-release dexamethasone 0.7 mg intravitreal implants (Ozurdex®; Allergan, Inc., Irvine, CA) in first-line treatment of retinal vein occlusion with macular edema.
A prospective study of 67 patients with recent (less than 3 months, n=17) and less recent (more than 3 months, n=12) retinal vein occlusion with macular edema treated with sustained-release dexamethasone 0.7 mg intravitreal implant was performed. 29 patients with a minimum follow-up time of 6 months (CRVO n=15, BRVO n=14) make up our study. Complete ophthalmic examination including visual acuity, fundus biomicroscopy, fundus photography, fluorescein angiography and spectral domain optical coherence tomography (Cirrus SD-OCT ; Carl Zeiss Meditec, CA) was performed at baseline and follow-up (1 week, 1 month, 2 months, 3 months, 4 months, 5 months and 6 months) and tolerance of the implant was assessed.
Twenty-nine eyes of 29 consecutive patients treated with a total of 29 sustained-release dexamethasone 0.7 mg intravitreal implants for macular edema associated with retinal vein occlusion were included. Thirty-three percent of patients gained at least 3 lines of best-corrected visual acuity (BCVA) at 2 months. Forty-four percent of eyes showed SD-OCT significative decrease of the edema following implant placement at 1 week (p<0.05). All eyes showed decrease of serous detachment of the neurosensory retina (not present in 26/29 cases at 1 month). Despite an increase of the macular edema in 57% of the eyes at 4 months, the final best-corrected visual acuity (BCVA) was still better at 6 months than BCVA at baseline. The safety profile was consistent with the results of a previous phase III trial of Ozurdex, and no serious ocular or systemic adverse events was observed during the follow-up period. High intraocular pressure (IOP) was mostly controlled with only one medication after OZURDEX. The peak of IOP was noted in 26% of the eyes at 2 months.
Sustained-release dexamethasone 0.7 mg intravitreal implant may be an effective treatment option to control macular edema in patients with retinal vein occlusion. Anatomical and functional benefits of OZURDEX are better when the treatment is done at an early stage.
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