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Safety outcomes after dexamethasone intravitreal implant injections

Session Details

Session Title: Vascular Diseases and Diabetic Retinopathy IV

Session Date/Time: Sunday 20/09/2015 | 09:00-10:30

Paper Time: 09:48

Venue: Athena.

First Author: : L.Distefano SPAIN

Co Author(s): :                  

Abstract Details

PURPOSE:To describe the systemic and ocular complications of dexamethasone intravitreal implant (Ozurdex®; Allergan Inc, Irvine, CA, USA), in 185 eyes of 177 patients, treated at a terciary hospital between april 2012 and june 2014. To measure intraocular pressure (IOP) changes before and after dexamethasone injection in patients with and without previous chronic open angle glaucoma (COAG).

Setting:

Vall d´Hebron Hospital. Barcelona - Spain.

Methods:

Retrospective and consecutive case series. Indications for injection, previous treatments received for macular edema, topical glaucoma medications received before and after injections, and number and interval between injections were described. IOP levels were measured 1 day, 1 week and 1, 2 and 4 months after implant. Percentage of patients with IOP raising more than 5 and 10 mmHg was also evaluated.

Results:

Mean follow-up was 12 months (range 5-26). Main indications were diabetic macular edema in 93 patients (50%), central retinal vein occlusion in 36 (19.5%), and branch retinal vein occlusion in 34 (18.4%). 56 eyes (30%) were treatment naïve. Patients received a mean of 2.3 (range 1-5) injections (5 months median interval between injections). No systemic complications were observed. Cataract progression was documented in 22.3% of 103 phakic patients. Ocular complications were present in 4.3% of cases: 1 sterile endophthalmitis, 1 acute infectious endophthalmitis, 1 retinal tear, 1 vitreous hemorrhage, 1 ocular hypotony and 1 case of anterior chamber migration of the implant. Mean IOP before treatment was 15.8 mmHg (SD 2.6). Highest mean IOP was recorded at the 2-months visit [19 mmHg (SD 6.4)]. IOP levels raised more than 5 and 10 mmHg in 76 (41%) and 28 patients (15%), respectively. 26% of subjects required ocular hypotensive medication after injection (mean of 1.4 drugs, range 1-4). No differences were found between subjects with and without previous COAG in terms of IOP raise (p=0.3) and topical glaucoma treatment added (p=0.85). IOP levels were higher than 35 mmHg in 5 patients; 2 of them underwent glaucoma surgery for refractory intraocular pressure.

Conclusions:

In our series, dexamethasone intravitreal implant demonstrated an adequate safe profile, if IOP and potential complications are regularly monitored. We found no differences in IOP raise in patients with and without previous COAG.

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