First Author: O.D'Anna SPAIN
Co Author(s): M. Asencio Duran J. Garcia Martinez M. Cidad Betegon F. Armada Maresca G. Amorena Santesteban I. Rosa Perez
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To determine the effects of dexamethasone intravitreal (IV) implant (Ozurdex®) 0.7 mg (Allergan, Inc., Irvine, CA, USA) in patients with macular edema (ME) of different aetiologies, assessing changes in visual acuity (VA) and central macular thickness (CMT), as well as ocular and systemic complications derived from it.
Hospital Universitario La Paz, Madrid, Spain.
Retrospective series of 330 eyes with ME of different aetiologies treated with IV dexamethasone implant between May 2011 and May 2016. Patient and ocular clinical characteristics, previous treatments, number of injections, change in visual acuity (VA), change in central macular thickness (CMT) and side effects were studied. Also the correlation between diabetic macular edema (DME) and these variables and the comparison with other aetiologies of ME was assessed.
We studied 330 eyes of 278 patients, with a mean age of 68.63 years. 52.5% had diabetes mellitus (DM), 50.4% were hypertensive and 13.2% smokers. The mean follow-up was 1.83 years with 714 implants in total. 42.42% of ME was secondary to DM, 26.06% to venous occlusions, 10.91% pseudophakic, 4.54% post-radiation and 4.54% was due to other aetiologies. 55.75% had been treated previously with anti-VEGF and 43.33% were naïve. The mean number of implants per eye was 2.19. 33.93% of eyes without previous glaucoma developed ocular hypertension (OHT) after one implant and 7.87% of the total had OHT with following injections. There was a statistically difference in the incidence of OHT between the group of DME and non-DME, being more frequently affected the non-DME (46.4% vs 27.3%, p<0.001). In 30.30% cataract progression was observed, requiring surgery 21.81%. 5 eyes had endophthalmitis, 5 vitreal haemorrhage, 3 migrations of the implant and 1 intracrystalline implant were documented. No systemic adverse events were reported. The mean change in CMT was -120.12 microns (-1106, +521) being more evident in the non-DME group with no statistically significance. The change in VA was -0.24 lines (-8, +8) at the end of the follow-up.
We present a retrospective case series with long follow-up based on clinical practice that shows applications, efficacy and safety of repeated injections of dexamethasone intravitreal (IV) implant 0.7 mg in ME from various pathologies. The study showing the implant being a valid therapeutic option, remembering that it can frequently cause OHT and cataracts, as well as other serious but infrequent complications.