J Korean Ophthalmol Soc.  2016 Dec;57(12):1918-1925. 10.3341/jkos.2016.57.12.1918.

One-year Outcome of Intravitreal Dexamethasone Implant for Macular Edema Secondary to Central Retinal Vein Occlusion

Affiliations
  • 1Department of Ophthalmology, Busan Paik Hospital, Inje University College of Medicine, Busan, Korea. maekbak@hanmail.net
  • 2Department of Ophthalmology, Pusan National University School of Medicine, Yangsan, Korea.
  • 3Department of Ophthalmology, Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea.
  • 4Department of Ophthalmology, Gyeongsang National University School of Medicine, Jinju, Korea.
  • 5Department of Ophthalmology, Yeungnam University College of Medicine, Daegu, Korea.
  • 6Institute of Environmental and Occupational Medicine, Department of Occupational and Environmental Medicine, Inje University College of Medicine, Busan, Korea.

Abstract

PURPOSE
In the present study, 1-year outcome of intravitreal dexamethasone implant in macular edema secondary to central retinal vein occlusion (CRVO) was evaluated.
METHODS
The medical records of 22 patients (22 eyes) with macular edema secondary to CRVO were reviewed retrospectively. All patients were treated with intravitreal dexamethasone implant more than twice a year and followed up at least for 1 year from the first dexamethasone implant injection. The best-corrected visual acuity (BCVA), central macular thickness (CMT), and intraocular pressure (IOP) were measured every 2 months after the first injection. Adverse effects, including cataract formation and elevation of IOP, were analyzed.
RESULTS
The mean patient age was 64.3 ± 9.5 years and 10 patients (45.5%) were male. The average number of injections was 2.4 ± 0.6 and the interval between the first and second injection was 22.0 ± 6.4 weeks. The mean BCVA (log MAR) was 0.82 ± 0.50 and 0.72 ± 0.62 at baseline and after 1 year, respectively. Vision was significantly improved for 8 months after the first injection (p < 0.05). However, vision was not different from baseline after 1 year. The CMT was significantly decreased compared to baseline (p < 0.001). Subgroup analysis revealed that BCVA was improved and CMT decreased significantly when intravitreal dexamethasone concentration was presumed sufficient. Moreover, CMT decreased significantly in hypertensive and ischemic groups compared with normotensive and non-ischemic groups, respectively (p < 0.001). Elevated IOP was observed in 6 eyes (27.3%), but all 6 eyes became normal after topical agent was applied. Cataract formation was observed in 3 eyes (13.6%).
CONCLUSIONS
Intravitreal dexamethasone implant resulted in visual acuity stabilization and macular edema reduction in patients having macular edema secondary to CRVO without significant adverse events.

Keyword

Central retinal vein occlusion; Dexamethasone implant; Macular edema; Ozurdex

MeSH Terms

Cataract
Dexamethasone*
Humans
Intraocular Pressure
Macular Edema*
Male
Medical Records
Retinal Vein*
Retrospective Studies
Visual Acuity
Dexamethasone

Figure

  • Figure 1. Best corrected visual acuity (BCVA) and central macular thickness (CMT) results. (A) BCVA was significantly increased at 2, 4, 6, 8 months after first injection. (B) CMT was significantly decreased at 2, 6, 8, 12 months after first injection. * p<0.05, against baseline by paired t-test; ** p<0.01, against baseline by paired t-test.

  • Figure 2. Univariate analysis (by generalized estimating equation [GEE]) for best corrected visual acuity (BCVA) and central macular thickness (CMT) change from baseline. (A) Hypertension (HTN) group showed no significant difference in BCVA but significantly large decrease in CMT compared tonon-HTN group. (B) Ischemic group neither showed significant difference in BCVA but presented significantly large decrease in CMT compared tonon-HTN group.


Cited by  3 articles

A Comparison of Three Intravitreal Modalities of Branch Retinal Vein Occlusion Macular Edema
Han Song, Hee Jun Song, Ji Ho Yang, Do Gyun Kim
J Korean Ophthalmol Soc. 2018;59(9):834-841.    doi: 10.3341/jkos.2018.59.9.834.

Prognosis and Disorganization of Retinal Inner Layers in Central Retinal Vein Occlusion with Dexamethasone Implantation
Hyun-Ji Kang, Yong-Wun Cho, Byeong-Sun Kim, Ji-Sung Jeong, Jong-Moon Park, In Young Chung, Woong-Sun Yoo
J Korean Ophthalmol Soc. 2019;60(11):1058-1063.    doi: 10.3341/jkos.2019.60.11.1058.

One-year Outcome of Intravitreal Dexamethasone Implant for Diabetic Macular Edema Patients
No Hae Park, Hyun Duck Kwak, Chang Ki Yoon, Ji Eun Lee, Min Sagong, Sang Joon Lee, Joo Eun Lee, Kun Hyung Kim, Hyun Woong Kim
J Korean Ophthalmol Soc. 2019;60(2):135-143.    doi: 10.3341/jkos.2019.60.2.135.


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