Treatment of macular edema associated with retinal vein occlusion using sustained-release dexamethasone implants in a clinical setting.

Purpose: To evaluate the clinical effect, safety, and administration procedure of slow-release dexamethasone implants (Ozurdex (R)) for macular edema secondary to retinal vein occlusion in clinical praxis. Methods: Data from 11 patients (4 eyes with central vein occlusion and 7 eyes with branch vein occlusion) were reviewed. Data were compiled and analyzed with respect to best-corrected visual acuity (BCVA), central macular thickness (CMT), intraocular pressure (IOP), and adverse events. Follow-up was 10 months. Changes in BCVA >= logMAR 0.2, IOP >= 5 mm Hg, and CMT >= 100 mu m were considered clinically relevant. Results: Two months after the first dexamethasone implant, BCVA improved from logMAR 0.65 +/- 0.2 to logMAR 0.34 +/- 0.1. All patients demonstrated a decrease in CMT from an initial average value of 632 +/- 178 mu m to 229 +/- 34 mu m. However, in 10 out of 11 eyes, macular edema recurred by month 4 through 5 and a second dexamethasone implant was administered. Two and 4 months after the second implant, BCVA was logMAR 0.36 +/- 0.2 and logMAR 0.40 +/- 0.2 and the CMT was 254 +/- 61 mu m and 357 +/- 81 mu m, respectively. The IOP increased 5.1 +/- 1.5 mm Hg 1 month after the first implant compared to baseline. In eyes with an IOP above 25 mm Hg (4 out of 11), pressure-lowering eyedrops were administered. Conclusions: Administration of dexamethasone implants induced a clinically relevant increase in visual acuity and a decrease in central macular thickness. In 91% of patients, macular edema recurred within 5 months and a second implant was administered. Adverse events, primarily increased IOP, were manageable. The injection procedure was relatively simple and uncomplicated.