Dexamethasone intravitreal implant for treatment of patients with recalcitrant macular edema resulting from Irvine-Gass syndrome

Invest Ophthalmol Vis Sci. 2013 May 7;54(5):3320-4. doi: 10.1167/iovs.12-11463.

Abstract

Purpose: To evaluate the effectiveness of a single intravitreal injection of dexamethasone implant, over 6 months in patients with recalcitrant CME due to Irvine-Gass syndrome.

Methods: Retrospective review of the medical records of nine patients with refractory macular edema (ME) due to Irvine-Gass syndrome, who underwent a single intravitreal injection of dexamethasone implant, Ozurdex, between November 2010 and January 2012, at the Instituto de Microcirurgia Ocular, Barcelona, Spain. All patients underwent a complete ophthalmic evaluation, including best-corrected visual acuity (BCVA) using standardized ETDRS charts, tonometry, fluorescein angiography, and spectral-domain optical coherence tomography with foveal thickness (FT) measurement.

Results: The mean duration of CME before treatment with Ozurdex was 9.1 months (range, 6-13 months). At baseline, the mean FT was 542.22 ± 134.78 μm. Mean (SD) values of FT did decrease to 350.88 ± 98.71 μm (P = 0.001) at month 1 and 319.22 ± 60.96 μm (P = 0.002) at month 3. Data on the 6-month follow-up showed a mild increase 398.33 ± 127.89 μm (P = 0.031). The mean (SD) change from baseline FT was 191.33 μm (a decrease value of 35%) at month 1, and 223.00 μm (decrease value of 41%) and 143.89 μm (decrease value of 26%) at month 3 and month 6, respectively. The baseline BCVA data were 0.62 ± 0.15 logarithm of the minimum angle of resolution (logMAR). The mean BCVA improved to 0.47 ± 0.21 logMAR (P = 0.008) and 0.37 ± 0.24 logMAR (P = 0.001) after month 1 and month 3, respectively. At the last visit (6-month follow-up), the mean BCVA was 0.37 ± 0.26 logMAR (P = 0.002).

Conclusions: In this study, both mean FT and mean BCVA had improved from baseline by 1 month after treatment with a dexamethasone implant, and the improvement remained statistically significant throughout the 6-month study.

Keywords: Irvine-Gass syndrome; Ozurdex; refractory macular edema.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Dexamethasone / administration & dosage*
  • Drug Implants
  • Female
  • Fluorescein Angiography
  • Glucocorticoids / administration & dosage*
  • Humans
  • Intravitreal Injections
  • Macular Edema / drug therapy*
  • Macular Edema / etiology
  • Macular Edema / physiopathology
  • Male
  • Middle Aged
  • Pseudophakia / drug therapy
  • Pseudophakia / etiology
  • Pseudophakia / physiopathology
  • Retrospective Studies
  • Tomography, Optical Coherence
  • Tonometry, Ocular
  • Treatment Outcome
  • Visual Acuity / physiology
  • Vitreous Body

Substances

  • Drug Implants
  • Glucocorticoids
  • Dexamethasone