Efficacy of dexamethasone intravitreal implant for refractory macular edema caused by retinal vein occlusion

Rehan M. Hussain, Thomas A. Ciulla, Lauren M. Ciulla, Bethany Sink, Alon Harris

Research output: Contribution to journalArticle

Abstract

Purpose: To investigate efficacy of dexamethasone intravitreal (DEX) implant in treating refractory macular edema caused by retinal vein occlusion. Methods: Retrospective chart review. Results: Twenty-two eyes with refractory macular edema caused by retinal vein occlusion were treated with a mean of 2.2 DEX over 12 months. Patient had previously received a mean of 7 treatments (laser, bevacizumab, and/or triamcinolone) for macular edema present for at least 4 months duration (mean 20.8 ± 17.6 months, range 4-72 months) before starting DEX. Mean baseline visual acuity was 20/91, and mean central subfield thickness was 506 μm. DEX improved mean best-corrected visual acuity to 20/75 and 20/66 at 7 weeks and 6 months follow-up, although it worsened to 20/132 at 12 months. Mean central subfield thickness improved to 292, 352, and 356 μm at 7 weeks, 6 months, and 12 months follow-up, respectively. There was a statistically significant association between number of DEX treatments and central subfield thickness (P = 3.28 × 10-9). There was a statistically significant association between number of days followed and best-corrected visual acuity (P = 0.006). Six of 12 (50%) phakic patients developed visually significant cataract requiring surgery. Five of 22 (23%) patients developed ocular hypertension (intraocular pressure > 30) and consequently did not undergo further treatment with DEX. Conclusion: DEX resulted in sustained anatomical reduction of retinal vein occlusion- associated refractory macular edema, although this did not translate into long-term bestcorrected visual acuity improvement in either phakic or pseudophakic patients, possibly related to chronic structural alterations in the retina despite reduction of edema.

Original languageEnglish (US)
Pages (from-to)294-299
Number of pages6
JournalRetinal Cases and Brief Reports
Volume12
Issue number4
DOIs
StatePublished - Jan 1 2018

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Keywords

  • BRVO
  • CRVO
  • Corticosteroids
  • Dexamethasone
  • Macular edema
  • OZURDEX
  • Optical coherence tomography

ASJC Scopus subject areas

  • Ophthalmology

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