Long-term probability of intraocular pressure elevation with the intravitreal dexamethasone implant in the real-world

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.

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Safety of 6000 intravitreal dexamethasone implants

British Journal of Ophthalmology ◽

10.1136/bjophthalmol-2019-313991 ◽

2019 ◽

Vol 104 (1) ◽

pp. 39-46 ◽

Cited By ~ 13

Author(s):

Bindu Rajesh ◽

Javier Zarranz-Ventura ◽

Adrian T Fung ◽

Catharina Busch ◽

Niroj Kumar Sahoo ◽

...

Keyword(s):

Intraocular Pressure ◽

Retinal Detachment ◽

Macular Oedema ◽

Real Life ◽

Cystoid Macular Oedema ◽

Dexamethasone Implant ◽

Intravitreal Dexamethasone Implant ◽

Intravitreal Dexamethasone ◽

Phakic Eyes

PurposeTo evaluate the real-life safety profile of intravitreal dexamethasone implant injection for various retinal conditions.MethodsRetrospective multicenter analysis of intravitreal dexamethasone implant injections (700 µg) due to various retinal conditions including central retinal venous occlusion (1861 injections), diabetic macular oedema (3104 injections), post-surgical cystoid macular oedema (305 injections) and uveitis (381 injections). The eyes were evaluated mainly for the occurrence of adverse events such as glaucoma, cataract, retinal detachment and endophthalmitis along during the follow-up period.ResultsA total of 6015 injections in 2736 eyes of 1441 patients (mean age of 65.7±12.9 years) were in total analysed over an average period of 18 months (range 6 months to 102 months). A total of 576 eyes (32.5% of the phakic eyes) developed cataract requiring surgical intervention. However, visually insignificant cataract progression was observed in another 259 phakic eyes (14.6%) which did not require surgical removal. A total of 727 eyes (26.5%) experienced an intraocular pressure (IOP) rise of >25 mm Hg, with 155 eyes (5.67%) having a prior history of glaucoma and 572 eyes (20.9%) having new onset IOP rise. Overall, more than 90% of eyes with IOP rise were managed medically, and 0.5% eyes required filtering surgery. Endophthalmitis (0.07%), retinal detachment (0.03%) and vitreous haemorrhage (0.03%) were rare. There was no significant change in visual acuity (p=0.87) and central macular thickness (p=0.12) at the last follow-up.ConclusionThis is the largest real-life study assessing the safety of intravitreal dexamethasone implant injections in various retinal conditions. Cataract progression and intraocular pressure rise are the most common side effects, but are often rather easily manageable.

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Long-Term Efficacy and Safety of Intravitreal Dexamethasone Implant for the Treatment of Diabetic Macular Edema

European Journal of Ophthalmology ◽

10.5301/ejo.5000787 ◽

2016 ◽

Vol 26 (5) ◽

pp. 454-459 ◽

Cited By ~ 18

Author(s):

Frederic Matonti ◽

Stephan Pommier ◽

Franck Meyer ◽

Christian Hajjar ◽

Pierre Yves Merite ◽

...

Keyword(s):

Macular Edema ◽

Diabetic Macular Edema ◽

Dexamethasone Implant ◽

Efficacy And Safety ◽

Term Efficacy ◽

Intravitreal Dexamethasone Implant ◽

Intravitreal Dexamethasone

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Efficacy and Safety in Retinal Vein Occlusion Treated with at Least Three Consecutive Intravitreal Dexamethasone Implants

Journal of Ophthalmology ◽

10.1155/2016/6016491 ◽

2016 ◽

Vol 2016 ◽

pp. 1-6 ◽

Cited By ~ 2

Author(s):

Julia Proença Pina ◽

Khalil Turki ◽

Julien Labreuche ◽

Alain Duhamel ◽

Thi Ha Chau Tran

Keyword(s):

Intraocular Pressure ◽

Cataract Surgery ◽

Retinal Vein Occlusion ◽

Multicenter Observational Study ◽

Vein Occlusion ◽

Intravitreal Dexamethasone Implant ◽

Significant Difference ◽

Elevated Intraocular Pressure ◽

Intravitreal Dexamethasone

Purpose. To evaluate the effects of repeated intravitreal dexamethasone implant (DI) (Ozurdex®) in eyes with macular edema (ME) due to retinal vein occlusion (RVO).Methods. Multicenter observational study including patients who received more than three consecutive DI on an “as-needed” basis for the treatment of ME in RVO.Results. A total of 18 eyes were included for analysis. Mean interval of retreatment with DI was 5.1 months between the first and second DI and 5.4 months following the second DI. Baseline BCVA was 0.74 ± 0.08 log-Mar; it significantly improved to 0.45 ± 0.04 2 months after the 3rd DI. There was no significant difference between the 3 first postinjection BCVA. CMT decreased from 617 μm ± 120 μm (baseline) to 330 ± 109 μm two months after the third DI. Elevated intraocular pressure occurred in 50% and was controlled medically. Cataract progression leading to cataract surgery occurred in 69% of phakic eyes after a mean interval of 17 months.Conclusion. Repeated DI on an “as-needed” basis, with a retreatment interval <6 months, are effective in the long term in the management of ME due to RVO. Rates of increased intraocular pressure and cataract surgery seem to be higher than previously described when eyes were followed during a longer period.

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