Abstract
BackgroundTo assess corneal endothelial cell changes after intravitreal dexamethasone (DEX) implant (Ozurdex®) injection in patients with macular edema secondary to retinal vein occlusion (RVO).MethodsTwenty-two eyes of 22 patients were assessed prospectively after intravitreal 0.7 mg DEX implant injection. Twenty-two eyes of 22 healthy volunteers served as control group. Corneal endothelial cell parameters including endothelial cell density (ECD), coefficient of variation of cell size (CV), percentage of hexagonality (Hex) and central corneal thickness (CCT) were analyzed before and 1 and 3 months after injection by specular microscopy. The results of the study were compared statistically.ResultsThere were 17 (77.3%) patients with branch RVO and 5 (22.7%) patients with central RVO. Mean intraocular pressure (IOP) was 14.73 mmHg before injection, 17.05 mmHg at 1 month and 17.15 mmHg at 3 months after injection. Mean IOP at 1 and 3 months were significantly higher than pre-injection value (p = 0.002 and p = 0.003, respectively). There was a statistically significant reduction in mean ECD at 3 months after injection compared to pre-injection and 1 month (p = 0.013, p = 0.009, respectively) in the injected eyes. Mean ECD showed no significant difference in the uninjected fellow eyes during the follow up (p>0.05). Mean CV and Hex did not reveal a statistically significant difference in injected and uninjected fellow eyes (p > 0.05). No significant change was observed in mean CCT values during the follow up (p = 0.8).ConclusionIntravitreal dexamethasone implant may cause a transient reduction in corneal endothelial cell density in short term without changing cell morphology.
Highlights
To assess corneal endothelial cell changes after intravitreal dexamethasone (DEX) implant (Ozurdex®) injection in patients with macular edema secondary to retinal vein occlusion (RVO)
Intravitreal dexamethasone implant may cause a transient reduction in corneal endothelial cell density in short term without changing cell morphology
There was no significant difference between mean central corneal thickness (CCT) values before intravitreal injection and at 1 and 3 months after intravitreal injection (p = 0.4, p = 0.5, respectively) (Table 2)
Summary
To assess corneal endothelial cell changes after intravitreal dexamethasone (DEX) implant (Ozurdex®) injection in patients with macular edema secondary to retinal vein occlusion (RVO). Corticosteroids are widely used in ophthalmology for their anti-inflammatory, antipermeability and antifibrotic properties. They modulate cellular proliferation, apoptosis, and development. Dexamethasone is a type of synthetic corticosteroid. It is one of the most commonly used corticosteroid in ophthalmology with similar indications as other corticosteroid preparations. Anti-inflammatory activity of dexamethasone is about six times stronger than that of prednisone or prednisolone and 30 times that of cortisone. Ozurdex® is an intravitreal implant containing 700 μg preservative-free dexamethasone (DEX) in a slow release drug delivery system.
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