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). 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 best-corrected 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 & brief reports
Volume12
Issue number4
DOIs
StatePublished - Sep 1 2018

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Retinal Vein Occlusion
Macular Edema
Dexamethasone
Visual Acuity
Triamcinolone
Ocular Hypertension
Intraocular Pressure
Cataract
Retina
Edema
Lasers
Therapeutics

ASJC Scopus subject areas

  • Medicine(all)

Cite this

EFFICACY OF DEXAMETHASONE INTRAVITREAL IMPLANT FOR REFRACTORY MACULAR EDEMA CAUSED BY RETINAL VEIN OCCLUSION. / Hussain, Rehan M.; Ciulla, Thomas A.; Ciulla, Lauren M.; Sink, Bethany; Harris, Alon.

In: Retinal cases & brief reports, Vol. 12, No. 4, 01.09.2018, p. 294-299.

Research output: Contribution to journalArticle

Hussain, Rehan M. ; Ciulla, Thomas A. ; Ciulla, Lauren M. ; Sink, Bethany ; Harris, Alon. / EFFICACY OF DEXAMETHASONE INTRAVITREAL IMPLANT FOR REFRACTORY MACULAR EDEMA CAUSED BY RETINAL VEIN OCCLUSION. In: Retinal cases & brief reports. 2018 ; Vol. 12, No. 4. pp. 294-299.
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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). 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 best-corrected visual acuity improvement in either phakic or pseudophakic patients, possibly related to chronic structural alterations in the retina despite reduction of edema.",
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N2 - 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). 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 best-corrected visual acuity improvement in either phakic or pseudophakic patients, possibly related to chronic structural alterations in the retina despite reduction of edema.

AB - 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). 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 best-corrected visual acuity improvement in either phakic or pseudophakic patients, possibly related to chronic structural alterations in the retina despite reduction of edema.

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