Uveitic macular edema response to intravitreal dexamethasone implant is independent of optical coherence tomography findings

Int Ophthalmol. 2021 Mar;41(3):787-796. doi: 10.1007/s10792-020-01631-x. Epub 2020 Nov 12.

Abstract

Purpose: To identify predictive response optical coherence tomography (OCT) findings in uveitic macular edema (UME) treated with intravitreal dexamethasone implant (DEX).

Methods: Retrospective study of 66 eyes (53 patients) treated with DEX for UME. SD-OCT macular scans were collected prior to DEX treatment and 6 weeks and 3 months after the DEX implant. OCT images were evaluated for qualitative and quantitative characteristics (central retinal thickness, CRT and macular volume, MV). A multivariate analysis of covariance (ANCOVA) was carried out to study the predictive influence of OCT and clinical covariates on outcomes. The main outcome was a composite endpoint based on the simultaneous gain of 5 or more letters associated with a 20% or more reduction in CRT.

Results: A significant improvement in BCVA at 6 weeks (mean change from baseline -0.2, SD 0.3) and 3 months (mean -0.2, SD 0.4) was observed after the DEX implant. A significant decrease in CRT (change from baseline -187.7 μm at 3 months) and MV (change from baseline -1.7 mm3 at 3 months) were also observed. An association of ≥ 5-letter improvement in BCVA and a ≥ 20% CRT reduction was observed in 44.6% of cases at 6 weeks and 31.4% at 3 months. ANCOVA multivariate analyses found CRT at 3 months independent from baseline clinical variables but from CRT.

Conclusion: DEX implant is an effective treatment for UME independently of basal characteristics, producing both a gain of visual acuity and improvement of macular anatomy by OCT measures at 3 months.

Keywords: Intravitreal dexamethasone implant; Optical coherence tomography; Uveitic macular edema; Uveitis.

MeSH terms

  • Dexamethasone / therapeutic use
  • Drug Implants
  • Glucocorticoids / therapeutic use
  • Humans
  • Intravitreal Injections
  • Macular Edema* / diagnosis
  • Macular Edema* / drug therapy
  • Macular Edema* / etiology
  • Retrospective Studies
  • Tomography, Optical Coherence
  • Treatment Outcome

Substances

  • Drug Implants
  • Glucocorticoids
  • Dexamethasone