Short-term effectiveness prognostic factors after dexamethasone intravitreal implant in macular edema due to retinal vein occlusion

Abstract

Introduction: The aim of this study was to describe functional and anatomical changes (best-corrected visual acuity [BCVA], central macular thickness [CMT], and central macular volume [CMV]) in patients with macular edema (ME) secondary to retinal vein occlusion (RVO) treated with intravitreal dexamethasone implant (IDI) and identify its clinical predictors in a real-world setting. Methods: Data from 111 patients who underwent IDI to treat RVO-associated ME were retrospectively reviewed. Demographic, preoperative, and postoperative variables were assessed using a logistic regression analysis to determine predictors of visual and anatomical improvement. Results: Mean BCVA, CMT, and CMV improved from baseline after IDI ( p < 0.001). The strongest predictors of different treatment outcomes were: a baseline BCVA ⩽60 ETDRS letters (OR = 50.600; p < 0.001) and first IDI injection (OR = 2.988; p < 0.001) for BCVA gain ⩾15 Early Treatment Diabetic Retinopathy Study (ETDRS) letters; a baseline BCVA ⩽60 ETDRS letters (OR = 7.893; p = 0.002) and non-chronic ME (OR = 3.875; p = 0.019) for BCVA ⩾80 ETDRS letters achievement; a baseline CMT ⩾400 µm (OR = 49.083; p  < 0.001) and a baseline CMV ⩾12 mm3 (OR = 4.235; p < 0.001) for CMT reduction ⩾50%; and a baseline CMT ⩾400 µm (OR = 11.471; p  < 0.001) and a baseline CMV ⩾12 mm3 (OR = 10.284; p < 0.001) for CMV reduction ⩾15%. Conclusion: This study confirmed the effectiveness of IDI to treat ME secondary to RVO and identified new predictive factors for two visual (⩾15 ETDRS letters gain and BCVA ⩾80 ETDRS letters) and two anatomical outcomes (>50% CMT and >15% CMV reduction).