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G. J. Mojica, J. K. Fernandes, S. M. Hariprasad; Evaluation of Intravitreal Dexamethasone Implant (OzurdexTM) in the Treatment of Refractory Macular Edema in Patients With Retinal Vein Occlusions. Invest. Ophthalmol. Vis. Sci. 2010;51(13):4722.
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Macular edema following retinal vein occlusions (central or branch retinal vein occlusion) remains an important cause of vision loss. Treatment options include photocoagulation, intravitreal agents such as avastin or corticosteroids, pars plana vitrectomy, or observation. OzurdexTM (0.7 mg dexamethasone intravitreal implant, Allergan Inc, Irvine CA) is the first FDA-approved pharmacologic agent for macular edema in patients with retinal vein occlusions and provides a promising treatment alternative for patients who have not responded to previous focal laser therapy or to other non-FDA approved pharmacologics. The randomized-controlled trials provided to the FDA for approval, evaluated patients with macular edema that had not received prior treatments. The purpose of this study is to evaluate the response to treatment with Ozurdex in patients who have not responded to previous therapies for macular edema.
After obtaining IRB approval at the University of Chicago Medical center, a prospective study of patients with retinal vein occlusion and secondary macular edema treated with a single injection of Ozurdex was conducted. Patients that received any treatment for macular edema following retinal vein occlusion were included in this study, regardless of treatment modality or duration of macular edema. Comprehensive evaluations including snellen BCVA and optical coherence tomography (OCT) were performed at the following time points after injection: 1 week, 1 month, and 3 months. Main outcome measures included assessment of snellen BCVA and central subfield thickness as measured with OCT.
Preliminary data include eight eyes of eight patients with vein occlusion (6 patients with BRVO, 2 patients with CRVO) and refractory CME. At 1 week after injection, central subfield thickness has decreased an average of 408 microns (range 273-543 microns). BCVA measured 1 week following injection reveals an improvement of 1-2 lines of vision.
In patients with retinal vein occlusions and secondary macular edema that is refractory to previous treatment modalities, OzurdexTM appears to lead to appreciable improvements in BCVA and central subfield thickness as measured by OCT.
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