Clinical Ophthalmology (Oct 2020)

Initial Ten Years of Experience with the Intravitreal Dexamethasone Implant: A Retrospective Chart Review

  • Wallsh J,
  • Luths C,
  • Kil H,
  • Gallemore R

Journal volume & issue
Vol. Volume 14
pp. 3097 – 3108

Abstract

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Josh Wallsh,1 Charlotte Luths,2 Haily Kil,2 Ron Gallemore2 1Albany Medical Center, Department of Ophthalmology, Albany, NY, USA; 2Retina Macula Institute and Research Center, Torrance, CA, USACorrespondence: Ron GallemoreRetina Macula Institute and Research Center, 4201 Torrance Blvd Suite 220, Torrance, CA 90503, USAEmail [email protected]: To evaluate the initial ten years of results from the intravitreal dexamethasone implant (DEX) in patients treated for retinal vein occlusion (RVO), diabetic macular edema (DME) or uveitis.Methods: Retrospective chart review of patients receiving DEX since its FDA approval. Best-corrected visual acuity (BCVA), central macular thickness (CMT) on optical coherence tomography, intraocular pressure and cataract status were collected. Baseline data were collected from the initial DEX and post-treatment data at the visit at least four weeks after the last DEX.Results: In total, 315 eyes received 1216 DEX over 63.9± 4.6 weeks. In the branch RVO (n=90), central RVO (n=59) and DME (n=62) cohorts, BCVA improved significantly (p< 0.05). The uveitis (n=154) cohort did not have a significant change in BCVA, 0.62± 0.04 to 0.61± 0.04 logMAR (p=0.34). Younger patients, vitrectomized eyes, and eyes without a history of glaucoma were associated with significantly better BCVA outcomes in the uveitis cohort (p< 0.05). Overall, CMT decreased significantly from 376.6± 6.8 to 322.7± 5.0 μm (p< 0.05). Intraocular pressure increased significantly (p< 0.001) and the percentage of patients requiring anti-glaucoma medications increased from 33.0% to 67.6%. Of phakic eyes, 58.8% (n=63) had cataract progression or underwent surgery with those who underwent surgery experiencing a significant improvement in BCVA (p< 0.05).Conclusion: Repeated DEX over extended follow-up offers significant anatomic benefits to all cohorts. Visual benefits are only seen in RVO, DME and select uveitis demographics.Keywords: uveitis, branch retinal vein occlusion, central retinal vein occlusion, diabetic macular edema, dexamethasone implant

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