Intravitreal dexamethasone implant in patients with persistent macular edema of variable etiologies

Ophthalmologica. 2014;232(2):83-91. doi: 10.1159/000360304. Epub 2014 Jun 12.

Abstract

Purpose: To examine the effect of an intravitreal dexamethasone drug delivery system (DEX-DDS) in the treatment of persistent cystoid macular edema (CME) of different etiologies.

Methods: Thirty-seven eyes with persistent CME were treated with DEX-DDS and analyzed for changes in best-corrected visual acuity (BCVA) and optical coherence tomography. Eyes were categorized into three groups: diabetic macular edema (DME, n = 14), vein occlusion (n = 15) and uveitis (n = 7).

Results: The mean follow-up was 22 ± 6.9 weeks. BCVA improved from 0.62 ± 0.38 to 0.35 ± 0.29 logMAR (p < 0.0001). Central macular thickness decreased by 184 ± 246 µm from baseline (p < 0.0001). In eyes where CME resolved and recurred, the average CME-free period was 11 weeks. The uveitis group showed faster CME resolution (2 weeks) and a longer CME-free period (20 weeks). Similar efficacy was shown for repeat DEX-DDS injections. The safety profile was good.

Conclusion: DEX-DDS is beneficial in the treatment of persistent CME. In cases of uveitis, CME resolution is rapid, resulting in the longest effect duration, when compared with other CME etiologies.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Dexamethasone / administration & dosage*
  • Drug Implants
  • Female
  • Follow-Up Studies
  • Glucocorticoids / administration & dosage*
  • Humans
  • Intraocular Pressure / drug effects
  • Intravitreal Injections
  • Macular Edema / classification
  • Macular Edema / drug therapy*
  • Macular Edema / etiology
  • Male
  • Middle Aged
  • Retrospective Studies
  • Visual Acuity / drug effects

Substances

  • Drug Implants
  • Glucocorticoids
  • Dexamethasone