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Dexamethasone Intravitreal Implant Rescue Treatment for Bevacizumab Refractory Macular Edema Secondary to Branch Retinal Vein Occlusion.
Korean J Ophthalmol. 2017 Apr; 31(2):108-114.KJ

Abstract

PURPOSE

To evaluate the prognostic factors and outcomes of dexamethasone intravitreal implant (DEX implant) for intravitreal bevacizumab refractory macular edema secondary to branch retinal vein occlusion (BRVO).

METHODS

This was a retrospective, interventional case series. Medical records were reviewed, and a total of 38 eyes that were treated with DEX implant for macular edema secondary to BRVO that did not respond to at least two consecutive intravitreal bevacizumab injections (IBIs) were included. Best-corrected visual acuity (BCVA), central subfield macular thickness, and central subfoveal choroidal thickness were evaluated at baseline, 2 months, and 6 months after DEX implantation.

RESULTS

Patients had undergone an average of 6.32 ± 4.66 prior IBI treatments. The average BCVA improved from 0.53 ± 0.26 to 0.41 ± 0.25 and 0.44 ± 0.23 logarithm of the minimal angle of resolution (logMAR) at 2 and 6 months, respectively (p < 0.001). The average central subfield macular thickness was 504.00 ± 121.54 µm at baseline and changed to 293.21 ± 74.17 µm and 427.28 ± 119.57 µm at 2 and 6 months, respectively (p < 0.001 and p = 0.002). Average central subfoveal choroidal thickness was 237.46 ± 92.21 µm at baseline and changed to 204.75 ± 74.74 µm and 226.86 ± 90.77 µm at 2 and 6 months, respectively (p < 0.001 and p = 0.455). Twenty-two eyes (58%) gained ≥0.1 logMAR at 2 months, while 16 eyes showed no improvement. Low BCVA at symptom presentation, low baseline BCVA, and shorter duration of macular edema were correlated with increased BCVA after treatment.

CONCLUSIONS

The DEX implant improves functional and anatomical outcomes for up to 6 months in about half of the patients treated with IBI refractory macular edema secondary to BRVO, particularly in patients with low initial and baseline BCVA.

Authors+Show Affiliations

Institute of Vision Research, Department of Ophthalmology, Yonsei University College of Medicine, Seoul, Korea.Institute of Vision Research, Department of Ophthalmology, Yonsei University College of Medicine, Seoul, Korea.Institute of Vision Research, Department of Ophthalmology, Yonsei University College of Medicine, Seoul, Korea.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

28367038

Citation

Lee, Kyou Ho, et al. "Dexamethasone Intravitreal Implant Rescue Treatment for Bevacizumab Refractory Macular Edema Secondary to Branch Retinal Vein Occlusion." Korean Journal of Ophthalmology : KJO, vol. 31, no. 2, 2017, pp. 108-114.
Lee KH, Kang EC, Koh HJ. Dexamethasone Intravitreal Implant Rescue Treatment for Bevacizumab Refractory Macular Edema Secondary to Branch Retinal Vein Occlusion. Korean J Ophthalmol. 2017;31(2):108-114.
Lee, K. H., Kang, E. C., & Koh, H. J. (2017). Dexamethasone Intravitreal Implant Rescue Treatment for Bevacizumab Refractory Macular Edema Secondary to Branch Retinal Vein Occlusion. Korean Journal of Ophthalmology : KJO, 31(2), 108-114. https://doi.org/10.3341/kjo.2017.31.2.108
Lee KH, Kang EC, Koh HJ. Dexamethasone Intravitreal Implant Rescue Treatment for Bevacizumab Refractory Macular Edema Secondary to Branch Retinal Vein Occlusion. Korean J Ophthalmol. 2017;31(2):108-114. PubMed PMID: 28367038.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Dexamethasone Intravitreal Implant Rescue Treatment for Bevacizumab Refractory Macular Edema Secondary to Branch Retinal Vein Occlusion. AU - Lee,Kyou Ho, AU - Kang,Eui Chun, AU - Koh,Hyoung Jun, Y1 - 2017/03/21/ PY - 2015/11/18/received PY - 2016/02/03/accepted PY - 2017/4/4/entrez PY - 2017/4/4/pubmed PY - 2017/8/17/medline KW - Bevacizumab KW - Dexamethasone KW - Intravitreal injections KW - Macular edema KW - Retinal vein occlusion SP - 108 EP - 114 JF - Korean journal of ophthalmology : KJO JO - Korean J Ophthalmol VL - 31 IS - 2 N2 - PURPOSE: To evaluate the prognostic factors and outcomes of dexamethasone intravitreal implant (DEX implant) for intravitreal bevacizumab refractory macular edema secondary to branch retinal vein occlusion (BRVO). METHODS: This was a retrospective, interventional case series. Medical records were reviewed, and a total of 38 eyes that were treated with DEX implant for macular edema secondary to BRVO that did not respond to at least two consecutive intravitreal bevacizumab injections (IBIs) were included. Best-corrected visual acuity (BCVA), central subfield macular thickness, and central subfoveal choroidal thickness were evaluated at baseline, 2 months, and 6 months after DEX implantation. RESULTS: Patients had undergone an average of 6.32 ± 4.66 prior IBI treatments. The average BCVA improved from 0.53 ± 0.26 to 0.41 ± 0.25 and 0.44 ± 0.23 logarithm of the minimal angle of resolution (logMAR) at 2 and 6 months, respectively (p < 0.001). The average central subfield macular thickness was 504.00 ± 121.54 µm at baseline and changed to 293.21 ± 74.17 µm and 427.28 ± 119.57 µm at 2 and 6 months, respectively (p < 0.001 and p = 0.002). Average central subfoveal choroidal thickness was 237.46 ± 92.21 µm at baseline and changed to 204.75 ± 74.74 µm and 226.86 ± 90.77 µm at 2 and 6 months, respectively (p < 0.001 and p = 0.455). Twenty-two eyes (58%) gained ≥0.1 logMAR at 2 months, while 16 eyes showed no improvement. Low BCVA at symptom presentation, low baseline BCVA, and shorter duration of macular edema were correlated with increased BCVA after treatment. CONCLUSIONS: The DEX implant improves functional and anatomical outcomes for up to 6 months in about half of the patients treated with IBI refractory macular edema secondary to BRVO, particularly in patients with low initial and baseline BCVA. SN - 2092-9382 UR - https://www.unboundmedicine.com/medline/citation/28367038/Dexamethasone_Intravitreal_Implant_Rescue_Treatment_for_Bevacizumab_Refractory_Macular_Edema_Secondary_to_Branch_Retinal_Vein_Occlusion_ L2 - https://ekjo.org/DOIx.php?id=10.3341/kjo.2017.31.2.108 DB - PRIME DP - Unbound Medicine ER -