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Dexamethasone implant in retinal vein occlusion- efficacy and safety using repeat injections as-needed

Session Details

Session Title: Quick Fire Free Paper 1

Session Date/Time: Thursday 11/09/2014 | 08:00-10:00

Paper Time: 08:40

Venue: Boulevard D

First Author: : S.Theodoropoulou UK

Co Author(s): :    O. Bartfai   R. Johnston   A. Sallam        

Abstract Details

Purpose:

To report the efficacy and safety of Ozurdex dexamethasone intravitreal implant (DEX implant) for eyes with macular oedema due to retinal vein occlusion (RVO), using an as-needed repeat injection protocol.

Setting:

Gloucestershire Hospitals NHS Foundation Trust, United Kingdom

Methods:

Retrospective consecutive case series of eyes receiving DEX implant for the treatment of macular oedema due to RVO in the context of entirely electronic clinical data entry within an electronic medical record. All participants were followed up for at least 12 months. Analysis included: visual acuity (VA), central 1mm retinal thickness (CRT), intraocular pressure (IOP) and complications.

Results:

108 eyes of 108 patients were included, 57 (52.8%) with central RVO and 51 (47.2%) with branch RVO. Eyes received 1-4 (mean, 1.4) DEX implants over 12 months. Mean duration of macular oedema before first DEX implant was 14.3 months. Mean interval for DEX implant re-injection was 6.7 months following the first injection and 6.6 months following the second. Mean VA improved from 0.83 logMAR at baseline to 0.67 logMAR at week 2, to 0.56 at 1 month and 0.64 at 2 months (p<0.001). Mean overall VA improvement at month 6 and 12 did not show significance (p>0.05). Mean CRT improved from 481 µm at baseline to 352.6 µm at week 2, to 309.6 µm at 1 month and 294.5 µm at 2 months (p<0.001). Similarly to VA, CRT reduction was not significant at months 6 and 12. Following DEX implant treatment, increased IOP (>25mmHg) occurred in 32 eyes (29.6%). Seven out of 22 (31.8%) eyes that were on IOP-lowering medication before initiation of treatment with DEX implant had increased IOP (>25mmHg) associated with DEX implant injection. Raised IOP was medically treated in all but one eye that required trabeculectomy. Three eyes developed neovascular glaucoma during the study.

Conclusions:

Retinal vein occlusion eyes treated with DEX implant injections on as-needed retreatment protocol had improved visual acuity and central retinal thickness. The intravitreal DEX implant does not last the 6 months implied by the retreatment protocol in the GENEVA trial.

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