Abstract
Purpose: :
To describe changes in vision and optical coherence tomography (OCT) measurements in the immediate weeks following treatment of retinal vein occlusion (RVO) with dexamethasone intravitreal implant (DEX; OZURDEX, Allergan, CA).
Methods: :
Patients with macular edema (ME) due to RVO were treated with DEX implant. Following treatment, ETDRS vision and spectral domain OCT measurements were taken at weeks 1, 2, 3, 4, 6, 8, 10, 12, 16, 20, and 24. Two-sample T-tests were used to compare outcomes between the BRVO and CRVO patient groups.
Results: :
15 patients were treated; 8 with branch retinal vein occlusion (BRVO) and 7 with central retinal vein occlusion (CRVO). Mean visual acuity at baseline was 45.7±17.8 letters, and mean baseline central retinal thickness (CRT) was 706.6±245.4 µm. A statistically significant decrease in CRT from baseline was seen as early as 1 week after treatment (490.9±314.9 µm) (p=0.02). The time to peak vision improvement amongst all patients was 9.06±5.44 weeks, and did not differ significantly between patients with BRVO vs. CRVO (p=0.75). Time to peak OCT response amongst all patients was 7.13±3.25 weeks. OCT response peaked significantly earlier in patients with BRVO (5.75±3.06 weeks) vs. CRVO (8.71±2.87 weeks) (p=0.038). 66.7% of patients with RVO gained at least 10 letters in an average of 3.20±2.94 weeks, and 46.7% gained at least 15 letters in an average of 3.00±1.15 weeks.
Conclusions: :
OCT thickness significantly decreased as early as 1 week after treatment with DEX implant. In patients gaining at least 10 letters of vision, response was seen approximately 3 weeks after treatment. Peak improvement in visual acuity occurred approximately 9 weeks post-treatment, and timing did not significantly differ between patients with BRVO versus patients with CRVO. Increased knowledge of the responses to DEX implant may help guide timing of complementary or repeat treatments.
Keywords: retina • macula/fovea • corticosteroids