Treatment of macular edema associated with retinal vein occlusion using sustained-release dexamethasone implants in a clinical setting.

Objective: To evaluate the clinical effect, safety, and administration procedure of slow-release dexamethasone implants (Ozurdex®) for macular edema secondary to retinal vein occlusion in clinical praxis.

Methods: Data from 11 patients (4 eyes with central vein occlusion and 7 eyes with branch vein oc-clusion) were reviewed. Data were compiled and analyzed with respect to best-corrected visual acuity (BCVA), central macular thickness (CMT), intraocular pressure (IOP), and adverse events. Follow-up was 10 months. Changes in BCVA ≥ logMAR 0.2, IOP ≥5 mm Hg, and CMT ≥100 μm were considered clinically relevant.

Results: Two months after the first dexamethasone implant, BCVA improved from logMAR 0.65 ± 0.2 
to logMAR 0.34 ± 0.1. All patients demonstrated a decrease in CMT from an initial average value of 
632 ± 178 μm to 229 ± 34 μm. However, in 10 out of 11 eyes, macular edema recurred by month 4 through 5 and a second dexamethasone implant was administered. Two and 4 months after the second implant, BCVA was logMAR 0.36 ± 0.2 and logMAR 0.40 ± 0.2 and the CMT was 254 ± 61 μm and 357 ± 81 μm, respectively. The IOP increased 5.1 ± 1.5 mm Hg 1 month after the first implant compared to baseline. In eyes with an IOP above 25 mm Hg (4 out of 11), pressure-lowering eyedrops were administered.

Conclusions: Administration of dexamethasone implants induced a clinically relevant increase in visual acuity and a decrease in central macular thickness. In 91% of patients, macular edema recurred within 5 months and a second implant was administered. Adverse events, primarily increased IOP, were manageable. The injection procedure was relatively simple and uncomplicated.