Intravitreal Dexamethasone Implant for the Treatment of Postoperative Macular Edema

2016 ◽  
Vol 236 (4) ◽  
pp. 181-185 ◽  
Author(s):  
André Klamann ◽  
Katharina Böttcher ◽  
Philipp Ackermann ◽  
Gerd Geerling ◽  
Marc Schargus ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Cataract Surgery ◽  
Macular Edema ◽  
Clinical Findings ◽  
Results Of Treatment ◽  
Intravitreal Dexamethasone Implant ◽  
Pars Plana ◽  
The Mean ◽  
Intravitreal Dexamethasone ◽  
Evidence Based Guidelines

Introduction: Macular edema after cataract surgery (Irvine-Gass syndrome) or pars plana vitrectomy is a postoperative complication which can lead to permanent visual loss. Increased inflammatory substances, such as prostaglandins and cytokines, are discussed to be causative. Currently, there are no evidence-based guidelines for the treatment of postoperative macular edema. Intravitreal dexamethasone (DEX) could be effective by its anti-inflammatory effect. We examined the functional and morphological results of treatment with 0.7 mg intravitreal DEX implant (Ozurdex®). Methods: In an observational study, we analyzed visual acuity (logMAR), intraocular pressure (IOP), clinical findings, and the central macular thickness (CMT, optical coherence tomography [OCT] Spectralis®, Heidelberg Engineering, 30° macular scan, 19 scans) of 12 eyes before and 1 month after the last DEX implantation (off-label use, Ozurdex®, Allergan, Inc., Irvine, CA, USA) for macular edema after cataract surgery or vitrectomy. Re-implantation was performed when OCT showed new intraretinal fluid along with a decrease in the patient's visual acuity. The mean follow-up was 14.4 ± 10.6 months. Results: Twelve eyes of 12 patients (4 female, 8 male) with a mean age of 62.6 ± 11.9 years were treated with a mean of 2.5 ± 1.6 intravitreal DEX implant injections. Prior to injection, the visual acuity was 0.74 ± 0.34 logMAR and the CMT was 608 ± 129 µm. One month after the last injection (after a mean of 437 ± 322 days), the CMT normalized (300 ± 90 µm, p < 0.01) in all cases with a visual acuity of 0.49 ± 0.43 logMAR (p < 0.01). After 8.1 ± 5.3 months, recurring macular edema could be completely reduced by re-injection in 66% (8 patients). Four patients had no recurrence. Postinjection, the mean IOP was 17.4 ± 6.8 mm Hg. Postinjection, 7 patients required topical antiglaucomatous therapy. Conclusions: Treatment with an intravitreal DEX implant is an effective therapy for postoperative macular edema. Each injection leads to a complete resorption of the edema with a significant increase in visual acuity.

Management of Pre-existing Macular Edema With Intravitreal Dexamethasone Implant in Eyes Undergoing Cataract Surgery

2019 ◽  
Vol 3 (4) ◽  
pp. 223-228
Author(s):  
Bradley T. Smith ◽  
Himanshu K. Banda
Keyword(s):  
Cataract Surgery ◽  
Macular Edema ◽  
Ocular Hypertension ◽  
Antihypertensive Agents ◽  
Cataract Extraction ◽  
Dexamethasone Implant ◽  
Intravitreal Dexamethasone Implant ◽  
History Of ◽  
The Mean ◽  
Intravitreal Dexamethasone

Purpose: The purpose of this study was to assess the efficacy and safety of intraocular dexamethasone implant (IDI) for pre-existing macular edema due to retinal vein occlusion (RVO), diabetes, and uveitis in eyes undergoing cataract surgery. Methods: A retrospective, noncomparative study was conducted. The medical record database was searched for patients meeting criteria of macular edema treated with IDI prior to cataract surgery. Results: Twenty-two patients had macular edema due to RVO (14 or 63.6%), diabetes (5 or 22.7%), or uveitis (3 or 13.6%). None had complications during cataract surgery. Thirteen (60%) were female with a mean age of 64 years (range, 25-82 years). The mean interval of dexamethasone implantation to cataract extraction was 49 days. The mean interval to follow-up optical coherence tomography was 65 days. Mean logarithm of the minimum angle of resolution (logMAR) visual acuity (VA) improved from .94 (20/150–) to .56 (20/70+) ( P = .004), with an average gain in VA measuring +0.37 logMAR (3 line gain). Mean central retinal thickness decreased from 474 to 378 μm ( P = .006) with an average reduction of 96 μm ( P = .006). Mean macular volume decreased from 10.29 mm3 to 9.78 mm3 ( P = .0002) with an average reduction of 0.51 mm3. Two patients developed postoperative ocular hypertension requiring treatment with topical antihypertensive agents. One had a combined glaucoma filtering procedure at the time of cataract surgery because of a history of ocular hypertension. Conclusions: The majority of this cohort had improved macular edema due to RVO, diabetes, and noninfectious uveitis while undergoing cataract surgery. IDI is an effective and safe treatment in these at-risk eyes.

scholarly journals Efficacy of Intravitreal Dexamethasone Implant in Different Patterns of Diabetic Macular Edema

2020 ◽  
Author(s):  
Claudio Furino ◽  
Alfredo Niro ◽  
Michele Reibaldi ◽  
Maria Oliva Grassi ◽  
Francesco Boscia ◽  
...  
Keyword(s):  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Serous Retinal Detachment ◽  
Intravitreal Dexamethasone Implant ◽  
The Mean ◽  
Group 2 ◽  
Intravitreal Dexamethasone ◽  
Pattern Group ◽  
Group 1

Purpose: Different patterns of diabetic macular edema (DME) suggest different pathogenesis and drug response. We evaluated the outcomes after intravitreal dexamethasone (DEX) implant for DME with or without serous retinal detachment (SRD). Methods: In this retrospective study, 22 naïve patients (23 eyes) with DME who underwent a single DEX implant were evaluated. Based on the optical coherence tomographic pattern of DME, 12 eyes had a cystoid macular edema pattern (Group 1) and 11 eyes had an SRD pattern (Group 2). The best-corrected visual acuity (BCVA), central retinal thickness (СRТ), central retinal volume (CRV), SRD height (SRDh), and intraocular pressure (IOP) were recorded before and at two and four months after the treatment. Results: There were no significant differences between the groups regarding demographic, clinical data and outcomes at baseline. In Group 1, the CRT and CRV significantly decreased at two months (P = 0.002 and P = 0.01, respectively), while the BCVA significantly improved at four months (P = 0.03). In Group 2, the CRT and CRV significantly improved (P < 0.01 and P ≤ 0.01, respectively) during the follow-up period. At four months, both groups showed a recurrence of DME, Group 1 in particular (two-month CRT reduction, –149 ± 127 μm vs four-month CRT reduction, –72 ± 174 μm; P = 0.04). The mean reduction in CRV was significantly different at four months (Group 1, –0.49 ± 1.7 mm3 vs Group 2, –1.3 ± 1.3 mm3; P = 0.04). In Group 2, the SRDh significantly decreased at two (P = 0.01) and four months (P = 0.01). Four cases with elevated IOP were managed. Conclusion: DEX implants were found to be effective in different patterns of DME. The SRD pattern may predict a longer-lasting morphologic efficacy.

scholarly journals Twelve-Month Follow-Up of Dexamethasone Implants for Macular Edema from Various Diseases in Vitrectomized and Nonvitrectomized Eyes

2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Eduardo A. Novais ◽  
Mauricio Maia ◽  
Paulo Augusto de Arruda Mello Filho ◽  
João Rafael de Oliveira Dias ◽  
José Maurício B. B. Garcia ◽  
...  
Keyword(s):  
Macular Edema ◽  
Safety Data ◽  
Common Adverse Event ◽  
Dexamethasone Implant ◽  
Intravitreal Dexamethasone Implant ◽  
The Mean ◽  
Pro Re Nata ◽  
Intravitreal Dexamethasone

Purpose. To evaluate the best-corrected visual acuity (BCVA), central retinal thickness (CRT), and the number of dexamethasone implants needed to treat cystoid macular edema (CME) from various etiologies over 12 months in vitrectomized and nonvitrectomized eyes.Methods. This multicenter retrospective cohort study included 112 patients with CME secondary to retinal diseases treated pro re nata (PRN) with a 0.7 mg intravitreal dexamethasone implant for 12 months. The BCVA, CRT, adverse events, safety data, and number of implants were recorded.Results. Vitrectomized and nonvitrectomized eyes received means of three implants and one implant, respectively, over 12 months (P<0.001). The mean BCVA of all patients improved from 0.13 at baseline to 0.33 (P<0.001) 12 months after one (P=0.001), two (P=0.041), and three (P<0.001) implants but not four implants (P=0.068). The mean baseline CRT decreased significantly (P<0.001) from 463 to 254 microns after 12 months with one (P<0.001), two (P=0.002), and three (P=0.001) implants but not with four implants (P=0.114). The anatomic and functional outcomes were not significantly different between vitrectomized and nonvitrectomized eyes. Increased IOP was the most common adverse event (23.2%).Conclusions. Dexamethasone implant administered PRN improved VA and decreased CRT in CME, with possible long-term clinically relevant benefits for treating CME from various etiologies. Vitrectomized eyes needed more implants compared with nonvitrectomized eyes.

Intravitreal slow-releasing dexamethasone implant for idiopathic neuroretinitis

2020 ◽  
pp. 112067212095307
Author(s):  
Osman Çekiç ◽  
Samet Gülkaş
Keyword(s):  
Visual Acuity ◽  
Macular Edema ◽  
Optic Disc ◽  
Vision Loss ◽  
Dexamethasone Implant ◽  
Optic Disc Edema ◽  
Intravitreal Dexamethasone Implant ◽  
Optic Disc Swelling ◽  
Intravitreal Dexamethasone

Introduction: The purpose of this report is to describe a successful management of idiopathic neuroretinitis with intravitreal dexamethasone implant. Method: Interventional case report. Clinical Case: A 34-year-old man with an acute painless unilateral vision loss, optic disc swelling, and a macular edema was diagnosed as idiopathic neuroretinitis, and he underwent 0.7 mg dexamethasone intravitreous implant injection. Macular edema responded quickly and visual acuity improved from 20/50 to 20/25 within 2 weeks and to 20/20 within a month. One month after the injection, optic disc edema disappeared. No recurrence occurred and visual acuity was stable at 20/20 during 3 years of follow-up. Conclusion: Idiopathic neuroretinitis can be treated with intravitreal dexamethasone implant.

scholarly journals EFFECT OF AN INTRAVITREAL DEXAMETHASONE IMPLANT ON DIABETIC MACULAR EDEMA AFTER CATARACT SURGERY

Retina ◽  
2018 ◽  
Vol 38 (3) ◽  
pp. 490-496 ◽  
Author(s):  
Pilar Calvo ◽  
Antonio Ferreras ◽  
Fadwa Al Adel ◽  
Wantanee Dangboon ◽  
Michael H. Brent
Keyword(s):  
Cataract Surgery ◽  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Dexamethasone Implant ◽  
Intravitreal Dexamethasone Implant ◽  
Intravitreal Dexamethasone

scholarly journals Long-term Clinical Outcomes of Cataract Surgery in Patients with Retinitis Pigmentosa

2021 ◽  
Vol 62 (7) ◽  
pp. 931-938
Author(s):  
Ji Hyun Yoon ◽  
Jong Woo Kim ◽  
Chul Gu Kim ◽  
Jae Hui Kim
Keyword(s):  
Visual Acuity ◽  
Retinitis Pigmentosa ◽  
Cataract Surgery ◽  
Macular Edema ◽  
Clinical Outcomes ◽  
Cystoid Macular Edema ◽  
Final Visit ◽  
Short Term ◽  
The Mean

Purpose: The long-term clinical outcomes of cataract surgery in patients with retinitis pigmentosa (RP) were evaluated. Methods: A retrospective analysis of medical records was performed for patients who were diagnosed with RP and underwent cataract surgery. Preoperative best-corrected visual acuity (BCVA) was compared with BCVA at 1 month postoperatively and at the final visit. The proportion of patients with cystoid macular edema development or aggravation after surgery was evaluated, as was the proportion of patients with intraocular lens subluxation/dislocation. For patients who underwent optical coherence tomography, factors associated with a BCVA of 0.5 or better at 1 month were analyzed. Results: In total, 133 eyes were included and the mean follow-up period was 58.7 months. The mean logarithm of minimal angle of resolution BCVA was 0.69 ± 0.65 at diagnosis. The BCVA was significantly improved to 0.51 ± 0.47 at 1 month postoperatively (p < 0.001). However, the BCVA at the final visit (0.70 ± 0.81) was similar to the baseline value (p = 1.000). Cystoid macular edema development or aggravation was noted in 8 eyes (6.0%) and intraocular lens subluxation/dislocation was noted in 4 eyes (3.0%). A subgroup analysis involving 108 eyes revealed that preoperative BCVA (p < 0.001) and ellipsoid zone status (p = 0.001) were associated with postoperative visual acuity. Conclusions: Short-term outcomes of cataract surgery in patients with RP were comparatively good. However, long-term visual deterioration was noted with disease progression. Preoperative BCVA and ellipsoid zone status are useful markers for predicting short-term visual outcomes.

scholarly journals Repeat Intravitreal Dexamethasone Implant for Refractory Cystoid Macular Edema in Syphilitic Uveitis

2018 ◽  
Vol 2018 ◽  
pp. 1-3 ◽  
Author(s):  
Cassandra C. Lautredou ◽  
Joshua S. Hardin ◽  
John R. Chancellor ◽  
Sami H. Uwaydat ◽  
Abdallah A. Ellabban ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Macular Edema ◽  
Treatment Response ◽  
Corticosteroid Therapy ◽  
Cystoid Macular Edema ◽  
Adjunctive Treatment ◽  
Hiv Positive ◽  
Dexamethasone Implant ◽  
Intravitreal Dexamethasone Implant ◽  
Intravitreal Dexamethasone

Purpose. To report the successful utilization of adjunctive repeat intravitreal corticosteroid therapy for the treatment of cystoid macular edema in syphilis-related uveitis. Methods/Patients. An HIV-positive patient with treated ocular syphilis who developed refractory cystoid macular edema (CME) was treated with repeat intravitreal corticosteroid therapy including dexamethasone intravitreal implants. Results. Treatment led to the resolution of CME and improvement in visual acuity. Conclusions. Intravitreal corticosteroid therapy may be a viable adjunctive treatment for refractory CME in patients with treated syphilitic uveitis. Corticosteroid-induced exacerbation of infection is unlikely in patients with an adequate serologic treatment response.

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