First Author: S.Malhorta INDIA
Co Author(s): D. Agarwal 0 0 0 0 0 0 0 0 0
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To evaluate the efficacy of Dexamethasone Intravitreal Implant in combination with modified grid laser photocoagulation for patients with macular edema due to central retinal vein occlusion
MGM Eye Institute, Raipur,India
In a prospective interventional case series comprising of eight patients with decreased visual acuity as a result of clinically detectable macular edema ≥300μm associated with central retinal vein occlusion( CRVO) were enrolled in the study.Patients with macular edema of duration between 6 weeks to 6 months and best-corrected visual acuity (BCVA) between (20/200) to (20/50) were included in the study . Patients with history of corticosteroid-responsive intraocular pressure (IOP) rise, glaucoma, cataract extraction, or other intraocular surgery within 3 months were excluded from the study.The main outcome measure was visual acuity at 1 and 4 months after injection. Secondary outcome measures included change in central macular thickness(CMT) on Optical coherence tomography (OCT) and changes in IOP following intravitreal dexamethasone implant. Retinal thickness in the central subfield as was measured by spectral optical coherence tomography(OCT).Patients underwent comprehensive ocular examination and OCT every monthly till 4 months.
Eight eyes of 8 patients were enrolled in the study. The mean age of the patients was 54.75±7.17 years. The means of BCVA and CMT at baseline, 1 and 4 months were compared by student’s t test and P<0.05 was considered statistically significant.The mean baseline BCVA was 0.625±0.28 logarithm of the minimum angle of resolution (logMAR). The mean BCVA improved to 0.50±0.29logMAR (P = 0.39) and 0.425±0.32 logMAR (P=0.03) from baseline mean BCVA after 1 and 4 months.The mean BCVA significantly improved from baseline at 4 months as compared to 1month. The mean baseline CMT was 703.63 ± 207 μm. The mean values of CMT changed from 258.13±83 μm at 1month to 285.63±106 μm at 4 months.The CMT reduction outcomes at 1 month ( P=0.003) and at 4 months (P=0.0007) were statistically significant, with respect to baseline data . Raised IOP at 1 months was seen in 2 patients which was controlled with antiglaucoma therapy.
The combination of dexamethasone intravitreal implant and macular grid laser photocoagulation gives concerted effort in improving BCVA and decreasing macular edema in central retinal vein occlusion and supplements each other .Futher randomized studies are needed to further evaluate the efficacy of this therapy