Retreatment with Ozurdex for Macular Edema Secondary to Retinal Vein Occlusion

Author:

Coscas Gabriel1,Augustin Albert2,Bandello Francesco3,de Smet Marc D.4,Lanzetta Paolo5,Staurenghi Giovanni6,Parravano Maria Cristina7,Udaondo Patricia8,Moisseiev Elad9,Soubrane Gisele10,Yatziv Yossi9,Loewenstein Anat9

Affiliation:

1. Centre Hospitalier Intercommunal de Créteil - France

2. Augenklinik, Städtisches Klinikum Karlsruhe - Germany

3. Eye Clinic, University Vita-Salute, Scientific Institute San Raffaele, Milan - Italy

4. Retina and Inflammation Unit, Clinique De Montchoisi, Lausanne - Switzerland

5. Department of Ophthalmology, University of Udine, and Istituto Europeo di Microchirurgia Oculare–IEMO, Udine - Italy

6. Department of Biomedical and Clinical Science “Luigi Sacco,” Sacco Hospital, University of Milan, Milan - Italy

7. Fondazione G.B. Bietti–IRCCS, Rome - Italy

8. Department of Ophthalmology, Nuevo Hospital Universitario y Politecnico La Fe, Valencia - Spain

9. Department of Ophthalmology, Tel Aviv Medical Centre, and the Sackler School of Medicine, Tel Aviv University - Israel

10. Department of Ophthalmology, Hotel Dieu, University Paris Centre, Paris - France

Abstract

Purpose To review the current practice of retreatment with Ozurdex injections in patients with macular edema (ME) secondary to retinal vein occlusion (RVO), and to recommend simple guidelines for Ozurdex reinjection in management of RVO. Methods This was a multicenter retrospective study of patients who received more than 2 Ozurdex injections for the treatment of ME in RVO. Recorded parameters included percent of patients with a 15-letter gain, visual acuity (VA) improvement from baseline, change in central macular thickness (CMT), time to reinjection, and occurrence of any complications. Results A total of 128 patients were included, 58 (45.3%) with central RVO (CRVO) and 70 (54.7%) with branch RVO (BRVO). Mean interval for Ozurdex reinjection was 5.9 months following the first injection and 8.7 months following the second. A >15-letter gain in VA was observed in 34 (48.8%) patients with CRVO and 16 (28%) patients with BRVO. Mean overall VA improvement at month 6 did not show significance (p>0.05); however, a significantly better mean VA improvement was seen in treatment-naïve eyes (p<0.03). The CMT was significantly reduced compared to baseline. The mean CMT decreased by 214.6 μm in eyes with BRVO (n = 53) and by 355.1 μm in eyes with CRVO (n = 63) (p = 0.002). Complication rates were very low. Conclusions Repeated injections of Ozurdex are effective and have a favorable safety profile. In current practice, the retreatment interval with Ozurdex injections might be too long, precluding the full therapeutic potential of this treatment modality. A strategy for managing RVO patients treated with Ozurdex on an as-needed basis is provided.

Publisher

SAGE Publications

Subject

Ophthalmology,General Medicine

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