Repeated Intravitreal Dexamethasone Implant (Ozurdex (R)) for Retinal Vein Occlusion

Purpose: To evaluate the effects of repeated intravitreal dexamethasone implant (IDI) (Ozurdex (R)) in eyes with macular edema (ME) due to retinal vein occlusion (RVO). Methods: We reviewed the charts of patients with RVO-related ME, who received repeated Ozurdex IDI (0.7 mg) on an 'as-needed' basis. Main outcome measures included changes in best-corrected visual acuity (BCVA), central macular thickness (CMT), retreatment interval, and incidence of side effects. Results: A total of 33 eyes were included for analysis. Retreatment with Ozurdex was judged necessary after 4.7 +/- 1.1 months from the first IDI (1st IDI) and 5.1 +/- 1.5 months from the second IDI (2nd IDI). Baseline BCVA was 0.65 +/- 0.43 logMAR; it significantly improved to 0.50 +/- 0.42 logMAR after 1.4 +/- 0.7 months from the 1st IDI (peaking efficacy) (p < 0.001) and to 0.48 +/- 0.44 logMAR after 1.8 +/- 0.8 months from the 2nd IDI (peaking efficacy) (p < 0.001). CMT decreased from 636 +/- 217 mu m (baseline) to 300 +/- 114 mu m, 1.4 +/- 0.7 months after the 1st IDI (p < 0.001), and to 298 +/- 91 mu m, 1.8 +/- 0.8 months after the 2nd IDI (p < 0.001). A rebound effect was recorded in 7 eyes after the 1st IDI (mean 168 +/- 158 mu m) and in 4 eyes after the 2nd IDI (mean 215 +/- 199 mu m). All eyes with a rebound effect improved again after a 2nd intravitreal Ozurdex injection. No serious adverse events were observed; 12 eyes developed a transient IOP increase, and cataracts were extracted in 2 eyes. Conclusion: Repeated intravitreal Ozurdex on an 'as-needed' basis, with a retreatment interval <6 months, may produce long-term clinically meaningful benefits in the treatment of ME due to RVO, without other significant side effects than expected after intraocular corticosteroid treatment. Copyright (C) 2012 S. Karger AG, Basel