Abstract
Purpose :
To evaluate the parameters in which the dexamethasone intravitreal implant (Ozurdex®) is used best to treat cystoid macular edema and/or ocular inflammation, including in patients with glaucoma. The main parameters analyzed were intraocular pressure (IOP), visual acuity, and central macular thickness in addition to the number of patients on intraocular pressure lowering therapy.
Methods :
A retrospective chart review of consecutive cases treated with Ozurdex intravitreal injection and followed for at least three months and no greater than 12 months. The central macular thickness (CMT) was assessed using spectral domain optical coherence tomography (SD-OCT). Several clinical and demographic parameters were also collected, including coexisting ocular conditions. Clinical data were collected from the initial visit at the time of injection, as well as 1 month, 2 months, 3 months, 6 months, 9 months, and 12 months post-injection. Patients with pre-existing glaucoma were included in the analysis.
Results :
Fifty-three eyes from 44 patients were included in the study. The cohort of patients were followed for an average of 11.2 months; 17 (38.6%) male and 27 (61.4%) female. An average of 1.84 Ozurdex implants were administered per eye over the 12 month follow-up period. Intraocular pressure had the greatest increase (2.89 mm Hg) at the 2 month follow-up visit. By 12 months there was a 0.34 mm Hg increase in intraocular pressure. The CMT had decreased by an average of 211 microns at the second month. The CMT decreased by an average of 112 microns at the 12 month follow-up visit. Visual acuity improved by an average of 2.3 lines Snellen equivalent at 2 months. Visual acuity at 12 months was improved by 0.22 Snellen equivalent. 13/53 (24.5%) eyes at baseline carried a diagnosis of glaucoma and were on intraocular pressure lowering therapy prior to Ozurdex. At 12 months follow-up 20/53 (37.7%) eyes were on intraocular pressure lowering therapy . One eye (1.9%) required subsequent endocyclophotocoagulation.
Conclusions :
Ozurdex intravitreal injection is an effective medication for treating a variety of conditions including ocular inflammation and cystoid macular edema with its efficacy peak at the 2nd month. Patients with controlled glaucoma may safely tolerate Ozurdex treatment. Ozurdex posed a low risk of meaningful IOP exacerbation in our cohort.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.