Abstract
Purpose :
In this case series, we outline and analyze the structural and tomographic changes in three cases of individuals that received a dexamethasone intravitreal implant (Ozurdex®) injection in one eye and a fluocinolone acetonide intravitreal implant (Iluvien®) injection in the fellow eye at the same time.
Methods :
The three cases were studied retrospectively to evaluate the relative efficacy between the two drugs. Best corrected visual acuity (BCVA), intraocular pressure (IOP), and maximum macular thickness (MMT) with optical coherence tomography (OCT) were taken as measurements along the timeline of follow up for comparison between the treatments.
Results :
Ozurdex® appeared to have a more pronounced and prompter effect when compared to Iluvien®. In two cases, Ozurdex® showed a quick onset with decreased MMT and improved BCVA within two months while Iluvien® took 4-6 months to provide a similar effect. The response to Ozurdex® demonstrated by these variables began to decrease by the fourth month of follow up, requiring repeat injection of medication. In the third case, where macular edema was less pronounced prior to treatment, Iluvien® provided a quick response that was sustained throughout a 22-month follow-up period. In this case, Ozurdex® also showed significant response in the fellow eye but required two additional doses to maintain this effect throughout the same 22-month period. In addition, the eyes injected with Ozurdex® appeared to maintain the structural integrity of the external limiting membrane (ELM) and photoreceptor outer segments (OS) throughout the follow-up period, while OCT of the eyes injected with Iluvien® began to demonstrate structural disintegration of these critical layers as soon as four months after injection.
Conclusions :
In patients with significant macular edema, intravitreal injection of Ozurdex® appears to provide quicker and more significant improvement in macular thickness, as well as better preservation of the outer retinal layers, when compared to intravitreal injection of Iluvien®. Further controlled studies comparing these two drugs are necessary.
This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.