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United Kingdom national database of intravitreal dexamethasone implant (Ozurdex®) for retinal vein occlusion related macular edema. A descriptive study of patients’ pre-treatment characteristics and treatment procedure

Session Details

Session Title: FP-15 Vascular Diseases and Diabetic Retinopathy V

Session Date/Time: Sunday 14/09/2014 | 08:00-10:00

Paper Time: 09:28

Venue: Boulevard D

First Author: : A.Sallam UK

Co Author(s): :    I. Stratton   R. Johnston           

Abstract Details

Purpose:

To describe patients’ demographics, existing ocular co-pathology and treatment procedures for patients treated with Ozurdex for macular oedema due to branch and central retinal vein occlusion in the UK National Health Service (NHS).

Setting:

A multicenter national database study of prospectively collected anonymized data within an electronic medical record system (Medisoft®).

Methods:

Data from participating 14 NHS centres across the UK were automatically extracted. For this report we analyzed data from 5 of these centres. Pre-treatment characteristics assessed included: patients’ age, gender, race and co-existing ocular pathology. Data pertaining to injection episodes were also analysed.

Results:

This study included 602 eyes of 567 patients receiving a total of 1162 intravitreal Ozurdex injections. Mean age of patients at the time of first injection episode was 70.8 years and 51% (289) of patients were females. 57% (323) were Caucasians, 3 % were Asians and in 40% (227), patients’ race was reported as unknown. Of all pre-existing ocular co-morbidities, age related macular degeneration was the commonest (16.8% %) while diabetic retinopathy accounted for 5.3% and glaucoma/ocular hypertension for 3.7%. Most Ozurdex injections were performed under topical anaesthesia (64.7%) with subconjunctival anaesthesia being used in 15.6%, subtenon anaesthesia in 4.8% and peri/retrobulbar in 0.9%. Most injections were administered in the inferior temporal quadrant (78.6%), followed by superior temporal (20.3%), inferior nasal (0.6%) and superior nasal quadrant (0.5%). 42.2% of all in injections were performed by consultants, 43.3% by independent non-consultants and 14.5% by trainees. Intraoperative complications were only reported in 4.2% of all administered injections, the commonest being subconjunctival haemorrhage (33%) and ocular pain (5.2%). Corneal abrasion was reported in 3.5% and vitreous haemorrhage was recorded in only 1.8%. There was no record of lens injury.

Conclusions:

Knowledge of disease associated co-morbidities and rate of operative complications of treatments has implications on service planning and delivery. Ozurdex is administered through a 22-gauge needle; however, this does not appear to be associated with significant operative complications or pain. Use of Ozurdex in patients with glaucoma is feasible but caution is required.

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