The Effect of Age and Initial Central Retinal Thickness on Earlier Need of Repeat Ozurdex Treatment for Macular Edema Due to Retinal Vein Occlusion: A Retrospective Case Series

J Ocul Pharmacol Ther. 2017 Dec;33(10):763-772. doi: 10.1089/jop.2017.0070. Epub 2017 Sep 26.

Abstract

Purpose: To evaluate the effects of dexamethasone intravitreal implant (Ozurdex) and identify risk factors for repeated treatment in patients with macula edema due to branch retinal vein occlusion (BRVO) or central retinal vein occlusion (CRVO).

Methods: Patients followed up for at least 6 months were enrolled from 2013 to 2016. Dexamethasone intravitreal implant was given as the baseline treatment. For evaluation of dexamethasone intravitreal implant effects and complications, the demographics, medical history, best-corrected visual acuity (BCVA), intraocular pressure, and central retinal thickness (CRT) were recorded. Multivariate Cox proportional hazard model and logistic regression were used to identify factors for repeated treatment.

Results: Twenty-three BRVO and 11 CRVO patients were enrolled. There were 15 males and 19 females. Fifteen (44.12%) patients needed only one dexamethasone intravitreal implant. The peak CRT and BCVA significantly improved. Comparing single-injection with multiple-injection group, age and initial CRT more than 400 μm were significantly higher in the multiple-injection group. From multivariate logistic regression and Cox proportional hazards analysis, patients with age older than 55 years and initial CRT more than 400 μm had higher risk for multiple injections.

Conclusions: Patients receiving as-needed schedule of dexamethasone intravitreal implant had significant peak CRT and BCVA improvement. Age older than 55 years and initial CRT more than 400 μm were significant risk factors associated with repeated dexamethasone intravitreal implant treatment.

Keywords: age; branch retinal vein occlusion; central retinal thickness; central retinal vein occlusion; dexamethasone intravitreal implant; macular edema.

MeSH terms

  • Age Factors
  • Dexamethasone / administration & dosage*
  • Drug Implants
  • Female
  • Glucocorticoids / administration & dosage*
  • Humans
  • Intraocular Pressure / physiology
  • Macular Edema / drug therapy*
  • Macular Edema / etiology
  • Macular Edema / physiopathology
  • Male
  • Middle Aged
  • Retina / pathology*
  • Retinal Vein Occlusion / complications
  • Retinal Vein Occlusion / drug therapy*
  • Retinal Vein Occlusion / physiopathology
  • Retreatment
  • Retrospective Studies
  • Tomography, Optical Coherence
  • Visual Acuity / drug effects
  • Visual Acuity / physiology
  • Vitreous Body / drug effects*

Substances

  • Drug Implants
  • Glucocorticoids
  • Dexamethasone