| Item type: | Article | ||||
|---|---|---|---|---|---|
| Journal or Publication Title: | Acta Ophthalmologica | ||||
| Publisher: | WILEY | ||||
| Place of Publication: | HOBOKEN | ||||
| Volume: | 91 | ||||
| Number of Issue or Book Chapter: | 5 | ||||
| Date: | 2013 | ||||
| Institutions: | Medicine > Lehrstuhl für Augenheilkunde | ||||
| Identification Number: |
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| Keywords: | MACULAR EDEMA SECONDARY; TRIAL; branch retinal vein occlusion; central retinal vein occlusion; dexamethasone; intravitreal injection; Ozurdex; slow-release drug | ||||
| Dewey Decimal Classification: | 600 Technology > 610 Medical sciences Medicine | ||||
| Status: | Published | ||||
| Refereed: | Yes, this version has been refereed | ||||
| Created at the University of Regensburg: | Yes | ||||
| Item ID: | 62393 |
Web of ScienceAbstract
Purpose: To evaluate the efficacy of intravitreal dexamethasone implants in eyes with cystoid macular oedema (CME) secondary to branch retinal vein occlusion (BRVO) or central retinal vein occlusion (CRVO) in the clinical everyday practice, examine the effects of early retreatment and compare the results with the GENEVA study. Methods: The charts of 102 patients (102 eyes) with CME secondary to ...
Abstract
Purpose: To evaluate the efficacy of intravitreal dexamethasone implants in eyes with cystoid macular oedema (CME) secondary to branch retinal vein occlusion (BRVO) or central retinal vein occlusion (CRVO) in the clinical everyday practice, examine the effects of early retreatment and compare the results with the GENEVA study. Methods: The charts of 102 patients (102 eyes) with CME secondary to BRVO (n=54) or CRVO (n=48) treated with Ozurdex at 8 centres were retrospectively reviewed. The patients were examined monthly over a 24-week period. Slit-lamp biomicroscopy, measurement of best-corrected visual acuity (BCVA) and measurement of the central retinal thickness (CRT) with spectral-domain optical coherence tomography (SD-OCT) were performed at baseline and at every follow-up examination. With progression of the disease (loss of one line or increased central retinal thickness (CRT) of 150m), a reinjection of Ozurdex or anti-VEGF was offered. Additional supplementing sectorial or panretinal laser photocoagulation was considered based on the individual status of the retina. Results: In the BRVO group, the median BCVA was 0.6 logMAR (Snellen equivalent of 0.25) at baseline and improved to 0.4 logMAR (Snellen equivalent of 0.40) after 4weeks, 0.3 logMAR (Snellen equivalent of 0.50) after 8weeks, 0.4 logMAR (Snellen equivalent of 0.40) after 12weeks, 0.5 logMAR (Snellen equivalent of 0.32) after 16weeks, 0.4 logMAR (Snellen equivalent of 0.40) after 20weeks and 0.45 logMAR (Snellen equivalent of 0.35) after 24weeks. The mean CRT was 559 +/-(SD) 209m at baseline and it decreased to 335 +/- 148m after 4weeks, 316 +/- 137m after 8weeks, 369 +/- 126m after 12weeks, 407 +/- 161m after 16weeks, 399 +/- 191m after 20weeks and 419 +/- 196m after 24weeks. In the CRVO group, the median BCVA was 0.7 logMAR (Snellen equivalent of 0.20) at baseline and improved to 0.4 logMAR (Snellen equivalent of 0.40) after 4weeks, 0.4 logMAR (Snellen equivalent of 0.40) after 8weeks, 0.6 logMAR (Snellen equivalent of 0.25) after 12weeks, 0.6 logMAR (Snellen equivalent of 0.25) after 16weeks, 0.5 logMAR (Snellen equivalent of 0.32) after 20weeks and 0.52 logMAR (Snellen equivalent of 0.30) after 24weeks. The mean CRT at baseline was 740 +/- 351m and it decreased to 419 +/- 315m after 4weeks, 352 +/- 261m after 8weeks, 455 +/- 251m after 12weeks, 497 +/- 280m after 16weeks, 468 +/- 301m after 20weeks and 395 +/- 234m after 24weeks. The BCVA improvement was statistically significantly better (p<0.05) compared with baseline in both groups at every follow-up visit. The mean CRT maintained significantly better when compared with baseline in both groups at all follow-up visits. Early reinjection was indicated in BRVO in 40.7% after 17.5 +/- 4.2weeks and in CRVO in 50% after 17.68 +/- 4.2. Six eyes (11%) with BRVO received a sectorial laser photocoagulation at a mean interval of 22 +/- 5.0weeks. Seven eyes (15%) with CRVO received a panretinal laser photocoagulation after a mean interval of 18 +/- 7.0weeks. The BCVA improvement and the mean CRT reduction were statistically significant (p<0.05) compared with baseline in both groups at every follow-up visit. Conclusions: Dexamethasone intravitreal implant resulted in a significant improvement of the BCVA and reduction of CME in patients with BRVO or CRVO. Early retreatment after 16weeks instead of 24weeks, like in the GENEVA study, was indicated in 50% to stabilize the improved functional and anatomical results.
Metadata last modified: 19 Dec 2024 08:38
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