Abstract
Purpose :
To assess the visual outcome and the effect on Central Retinal Thickness (CRT) of the intravitreal sustained-release 0.7 mg dexamethasone implant (Ozurdex; Allergan, Irvine, CA) in pseudophakic patients with DMO at baseline and in one month, three months and six months post Ozurdex injection.
Methods :
Patients were identified by retrospective review of electronic records of patients at Moorfields Eye Hospital who were diagnosed with DMO and had Ozurdex treatment between November 2015 and April 2018. Best corrected visual acuity (BCVA) was assessed through Early Treatment Diabetic Retinopathy Study (ETDRS) and CRT was measured by spectral-domain optical coherence tomography.
Results :
Overall, 61 eyes of 60 patients were included. The mean age was 72 +/-8,94 years. 40 eyes were previously treated for DMO with a mean number of 5,6 anti-Vascular Endothelial Growth Factor(anti-VEGF) injections. The indications for Ozurdex implant was the poor response to previous anti-VEGF treatment(62,3%), the systemic contraindications for anti-VEGF injections(11,5%) and the inflammatory component in the aetiology of DMO(26,2%). At baseline, the mean BCVA was 55+/-16,7 letters and the mean CRT was 414,7+/-131,7 μm. At 1-month review, the mean BCVA was 57+/-15 letters. 47,5% of the eyes had improved BCVA(31% of them had increase in BCVA of more than 10 letters) and 26% of the eyes had stable vision. The mean CRT was 332,5+/-119 μm. At 3-month follow up, the mean BCVA was 56,8+/-17 letters with 26% of the eyes to have improved vision and 50% to have stable vision. The mean CRT was increased to 370,7+/-148,4 μm. At 6-month review, the mean BCVA reduced to 54,3+/-20 letters (44,3% of the eyes showed stable BCVA and 28% of them had deterioration) and the mean CRT was increased to 408,2+/-131,7 μm. During the 6-month follow up, only 5 eyes (8,2%) demonstrated issues with Intra-Ocular Pressure (IOP) that needed IOP lowering medication.
Conclusions :
Ozurdex treatment in patients with DMO is associated with improvement of the mean BCVA and decrease of the mean CRT and this outcome is maintained at least 3 months after the implantation. So, the Ozurdex can be considered as an efficacious treatment option in cases of DMO where anti-VEGF injections are not effective or contrindicated or in cases where DMO is combined with inflammatory component.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.