Intraocular Pressure after Intravitreal Injection of Dexamethasone Implant for Macular Edema Resulting from Retinal Vein Occlusion

Aim: To analyze the effectiveness of intravitreal injection of an anti-VEGF agent (ranibizumab) and an dexametazon implant for the intravitreal injection, in real clinical life.Patients and Methods. 137 patients with MO due to retinal venous occlusion were included in the study. Patients were retrospectively divided into groups: patients who received monotherapy with ranibizumab 94 people; and monotherapy with dexamethasone implant — 15 patients; patients who initially were injected with a dexamethasone implant, but due the study transferred to ranibizumab 15 patients; patients who initially received ranibizumab, but then transferred to the dexamethasone implant -13. For the treatment of macular edema were used an anti-VEGF agent — ranibizumab (Lucentis) 0.05 ml (0.5 mg) manufactured by Novartis (Switzerland) or glucocorticosteroid — dexamethasone implant for intravitreal injection of 0.7 mg (Ozurdex) manufactured by Allergan Pharmaceutical Ireland (Ireland). The injections were administered on a pro re nata basis (the presence of macular edema). Standard ophthalmological examination and fluorescent angiography (PAG), optical coherent tomography (OCT), optical coherence tomography angiography (OCT-A) were used. Visual acuity changes (BCVA), central retinal thickness (CRT) and intraocular pressure (IOP) were analyzed depending on the study group (group 1–4), the duration of treatment and the number of injections. Results: In group 1, from 1 to 8 IVVs were performed in 24 months, an average of 3.77. In group 2, from 1 to 4 intravitreal injections were performed in 24 months, an average of 1.37. In group 3, from 1 to 2 of intravitreal injections Ozurdex and from 1 to 4 intravitreal injections of ranibizumab for 24 months. In group 4, from 1 to 4 intravitreal injections of anti-VEGF drug and from 1 to 4 intravitreal dexamethasone implant were performed in 24 months of follow-up. Monotherapy with the Ozurdex drug (12 months) had the most stable effect, with a relapse of the process, repeated injections were required, conducted only in 3 out of 15 patients. Conclusion: In real clinical practice, the dexamethasone implant showed a good safety profile and high efficacy in the resorption of macular edema in patients with retinal vein occlusion, which corresponds to the clinical trials that was made earlier.

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Effect of intravitreal injection of dexamethasone implant on corneal endothelium in macular edema due to retinal vein occlusion

Cutaneous and Ocular Toxicology ◽

10.3109/15569527.2014.975242 ◽

2014 ◽

Vol 34 (4) ◽

pp. 294-297 ◽

Cited By ~ 4

Author(s):

Nilufer Ilhan ◽

Mesut Coskun ◽

Ozgur Ilhan ◽

Esra Ayhan Tuzcu ◽

Mutlu Cihan Daglıoglu ◽

...

Keyword(s):

Macular Edema ◽

Intravitreal Injection ◽

Retinal Vein Occlusion ◽

Corneal Endothelium ◽

Dexamethasone Implant ◽

Vein Occlusion

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Reflux after intravitreal injection: an anterior segment optical coherence tomography study

Advances in Ophthalmology & Visual System ◽

10.15406/aovs.2020.10.00376 ◽

2020 ◽

Vol 10 (1) ◽

pp. 18-21

Author(s):

Ismail Ersan ◽

Aydin Yildiz ◽

Ismail Ersan ◽

Aydin Yildiz

Keyword(s):

Intraocular Pressure ◽

Intravitreal Injection ◽

Retinal Vein Occlusion ◽

Anterior Segment ◽

Age Related Macular Degeneration ◽

Dexamethasone Implant ◽

Vein Occlusion ◽

Age Related ◽

Injection Methods ◽

23 Gauge

Purpose: To investigate the intraocular pressure and conjunctival thickness changes following the intravitreal injection Methods: Sixty eyes of 60 patients having intravitreal injection for age-related macular degeneration, macular edema associated with diabetes, central retinal vein occlusion, and branch retinal vein occlusion were enrolled. Intraocular pressure (IOP) was measured by Tonopen-Avia (Reichert Inc., NY, USA) in sitting position and five superior-temporal conjunctival images were obtained using the Anterior Segment 5 Line Raster scanning protocol of Cirrus HD-OCT 4000 (Carl Zeiss Meditec, Dublin, CA, USA) just before the intravitreal injection. 0.05 ml bevacizumab with 27-gauge needle, 0.05 ml ranibizumab with 30-gauge needle, or dexamethasone implant with 23-gauge needle was injected into the vitreous cavity. The second IOP measurements and OCT measurements were taken within 5 mins of injection. Results: The ranibizumab group included 25 subjects, the bevacizumab group included 23 subjects, and the dexamethasone group included 12 subjects. IOP increases following intravitreal injection were significantly higher in ranibizumab and bevacizumab groups compared with Dexamethasone implant group (p<0.001 and p=0.007, respectively). Although, the increase of conjunctival thickness following the intravitreal injection was highest in Dexamethasone implant group, the differences between the groups did not reach statistically significance (p=0.153). Conclusion: A higher IOP elevation is observed if a small-gauge needle is used for intravitreal injection. The conjunctival thickness changes following the intravitreal injection did not differ between the groups

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Safety and effectiveness of intravitreal injection of dexamethasone for macular edema secondary to retinal vein occlusion: a meta-analysis

10.21203/rs.2.21159/v1 ◽

2020 ◽

Author(s):

Gao Xiaorong ◽

Dan Yujiao ◽

Chen Jie ◽

Tian Gang ◽

Yue He

Keyword(s):

Intraocular Pressure ◽

Macular Edema ◽

Intravitreal Injection ◽

Retinal Vein Occlusion ◽

Retinal Thickness ◽

Meta Analysis ◽

Central Retinal Thickness ◽

Vein Occlusion ◽

Corrected Visual Acuity ◽

Long Time

Abstract Background: This meta-analysis aimed to investigate the efficacy and safety of intravitreal injection of dexamethasone (DEX) in treating macular edema secondary to retinal vein occlusion. Method: PubMed, Embase-clinical key, clinicaltrials.gov, Web of Science, and SinoMed were searched to compare the application of DEX implant in patients with retinal vein occlusion secondary macular edema (RVO-ME). The central retinal thickness, best-corrected visual acuity (BCVA), postoperative intraocular pressure, and postoperative cataract were extracted. RevMan 5.3 was used to analyze and evaluate the data. Results: This study was based on six randomized trials. A total of 393 eyes were studied. DEX implant could effectively reduce macular edema caused by retinal vein occlusion. After 6 months, the drug could significantly improve the patients’ BCVA [95% confidence interval (CI), 9.669–21.649, P = 21.649]. At the same time, it also could significantly reduce the patients’ central retinal thickness (95% CI: 274.965–142.236, P = 0.0000). DEX implant could increase the intraocular pressure in some patients and greatly increase the risk of cataracts. Conclusions: DEX implant can effectively improve the BCVA of patients with RVO-ME, reduce the central thickness of the retina, and reduce the number of injections for a relatively long time. Therefore, intravitreal injection of DEX can be used as an effective method for treating RVO-ME.

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Retinal venous pressure is decreased after anti-VEGF therapy in patients with retinal vein occlusion–related macular edema

Graefe s Archive for Clinical and Experimental Ophthalmology ◽

10.1007/s00417-020-05068-x ◽

2021 ◽

Author(s):

Teruyo Kida ◽

Josef Flammer ◽

Katarzyna Konieczka ◽

Tsunehiko Ikeda

Keyword(s):

Macular Edema ◽

Intravitreal Injection ◽

Retinal Vein Occlusion ◽

Venous Pressure ◽

Decisive Role ◽

Retinal Venous Pressure ◽

Vein Occlusion ◽

Anti Vegf ◽

Significant Difference ◽

Endothelial Growth Factor

Abstract Purpose The pathomechanism leading to retinal vein occlusion (RVO) is unclear. Mechanical compression, thrombosis, and functional contractions of veins are discussed as the reasons for the increased resistance of venous outflow. We evaluated changes in the retinal venous pressure (RVP) following intravitreal injection of anti-vascular endothelial growth factor (VEGF) agent to determine the effect on RVO-related macular edema. Methods Twenty-six patients with RVO-related macular edema (16 branch RVOs [BRVOs] and 10 central RVOs [CRVOs], age 72.5 ± 8.8 years) who visited our hospital were included in this prospective study. Visual acuity (VA), intraocular pressure (IOP), central retinal thickness (CRT) determined by macular optical coherence tomography, and RVP measured using an ophthalmodynamometer were obtained before intravitreal injection of ranibizumab (IVR) and 1 month later. Results Comparison of the BRVOs and CRVOs showed that VA was significantly improved by a single injection in BRVOs (P < 0.0001; P = 0.1087 for CRVOs), but CRT and RVP were significantly decreased without significant difference in IOP after the treatment in both groups (P < 0.0001). Conclusion The anti-VEGF treatment resulted in a significant decrease in the RVP, but the RVP remained significantly higher than the IOP. An increased RVP plays a decisive role in the formation of macula edema, and reducing it is desirable.

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