The efficacy and safety of intravitreal dexamethasone implant for the treatment of macular edema related to retinal vein occlusion: Real-life data and prognostic factors in a Turkish population


Kanra A. Y., Akçakaya A. A., Yaylalı S. A., Altınel M. G., Sevimli N.

Turkish Journal of Ophthalmology, cilt.47, sa.6, ss.331-337, 2017 (Scopus, TRDizin)

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 47 Sayı: 6
  • Basım Tarihi: 2017
  • Doi Numarası: 10.4274/tjo.75317
  • Dergi Adı: Turkish Journal of Ophthalmology
  • Derginin Tarandığı İndeksler: Scopus, TR DİZİN (ULAKBİM)
  • Sayfa Sayıları: ss.331-337
  • Anahtar Kelimeler: Anti-vascular endothelial growth factor, intravitreal dexamethasone implant, macular edema, retinal vein occlusion
  • Sağlık Bilimleri Üniversitesi Adresli: Evet

Özet

Objectives: To evaluate the efficacy and safety of dexamethasone (DEX) implants as mono or combination therapy for macular edema in retinal vein occlusion (RVO) with real-life conditions, and to detect factors that influence final visual acuity. Materials and Methods: Twenty-five eyes with macular edema secondary to RVO underwent assessments for central macular thickness (CMT), best-corrected visual acuity (BCVA), adverse events, and also morphologic changes in optical coherence tomography at an interval of 4-8 weeks after at least one DEX implant. Results: Seventeen eyes with branch RVO and 8 eyes with central RVO were eligible for the study. The mean follow-up duration was 17 months (range, 12-26 months). Both mean BCVA (p=0.009) and CMT (p=0.006) improved significantly, and visual gains of ≥3 lines were achieved in 32% and ≥2 lines in 52% at the end of the follow-up period. The most powerful individual predictor of final visual acuity was baseline BCVA (r2=0.611, p<0.001, stepwise multiple regression), but the most efficient model was the combination of the ellipsoid zone (EZ) integrity and baseline BCVA (r2=0.766, p<0.001, stepwise multiple regression). Complication rates were very low after repeated DEX implants. Conclusion: DEX implant seems to be an effective and safe treatment for macular edema in RVO despite negative real-life factors, and visual outcomes are associated with baseline visual acuity and EZ integrity.