Dexamethasone intravitreal implant therapy for macular edema secondary to retinal vein occlusion and conversion to Lucentis in clinical practice

Session Details

Session Title: Free Paper Session 7: Vascular Diseases & Diabetic Retinopathy II

Session Date/Time: Thursday 07/09/2017 | 14:30-16:00

Paper Time: 15:12

Venue: Room 117

First Author: : J.Than UK

Co Author(s): :    S. Balal   S. Tekriwal   A. Lobo                       

Abstract Details

Purpose:

The safety and effectiveness of multiple dexamethasone implants (DEX) in retinal vein occlusions (RVO) continues to be elucidated. When treatment fails, conversion to alternative therapies is required, but outcomes when switching to vascular endothelial growth factor (VEGF) inhibitors such as Lucentis (Ranibizumab) remain poorly understood.

Setting:

Moorfields Eye Clinic, Bedford Hospital, United Kingdom.

Methods:

We conducted a retrospective study evaluating the outcomes for patients treated with multiple DEX injections and those requiring conversion to Lucentis over 5 years at a single-centre. All patients had undergone a complete ophthalmic examination, optical coherence tomography (OCT). Outcome measures includes central retinal thickness (CRT) on OCT, treatment for intraocular pressure (IOP) rise, cataract treatment and best corrected visual acuity (BCVA).

Results:

Patients (n=129) had a mean follow-up of 25.3 months. The mean improvement in central retinal thickness (CRT) was 312μm post-final DEX (p=<0.0001). Mean peak best corrected visual acuity (BCVA) post-final DEX was an improvement of 16 ETDRS letters (p<0.0001). 43.4% patients developed intraocular hypertension and 50.48% phakic at baseline patients were diagnosed with cataract after DEX. 49 patients were converted and received a mean of 9.37 Lucentis injections with a mean improvement in BCVA of 15 ETDRS letters (p<0.0001) compared with final DEX.

Conclusions:

This study supports the use of Lucentis in eyes previously treated with DEX and provides long-term safety and efficacy data of multiple DEX injections.

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