A 2-year retrospective study of the treatment of retinal vein occlusion with dexamethasone 0.7 mg intravitreal implant (Ozurdex®): an emphasis on combination therapy.

Abstract

Introduction: Retinal Vein Occlusion (RVO) is the second commonest retinal vascular pathology after diabetic retinopathy. Ozurdex is a sustained-release 0.7 mg dexamethasone intravitreal implant which has been approved to treat adults with RVO, non-infectious posterior uveitis and pseudophakic patients with diabetic macular oedema. We aim to assess its efficacy and safety in a retrospective study which included 49 eyes of 46 consecutive patients over a 24-month follow up period. Methods: Data was collected retrospectively from paper and electronic patient records. Statistical analysis was performed using Microsoft Excel and SPSS. The paired student t- test was used to compare pre and post treatment data. Categories analysed included demographics, ocular and systemic co-morbidities, type of RVO, duration of macular edema prior to treatment, additional treatments with laser/anti-VEGF, pre and post treatment visual acuity, intraocular pressure, central macular thickness and complications. Results: Patients had equal gender distribution; age ranged between 42 to 91 years and the mean duration of macular oedema is 6.9 months (SD ± 9.24). Additional treatment: Laser PRP: Pretreatment: 16%, Post treatment: 22%. Anti VEGF: Pre-treatment: 6%, Post treatment: 42%. Number of Implants: 34.7% had 2 implants, 10.2% had 3 implants and 2.1% had 4 implants. Mean duration of repeat implant- 6.54 months (SD ±0.55). Mean reduction in CMT is 181.3μm (SD ± 210.92). The commonest complication at the end of the study was found to be high IOP in 26.5%. Visual outcome improved by > 15 letters in 32% at 2 months, 30% at 6 months and 28.5% at 2 years (p<0.061). Conclusion: This is a real-life data showing the effect of Ozurdex® in RVO. Our results are comparable with major studies like the Geneva study. Rates of complications were comparable. We show that combination therapy was superior to monotherapy.