Evaluation of Peripapillary Nerve Fiber Layer after Dexamethasone Implantation (Ozurdex) in Branch Retinal Vein Occlusions.

Muhammed Nurullah Bulut,Ulviye Kıvrak,Yusuf Özertürk,Kezban Bulut,Ümit Çallı,Güzide Akçay

doi:10.1155/2016/2050796

Muhammed Nurullah Bulut, Ulviye Kıvrak + Show 4 more

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https://doi.org/10.1155/2016/2050796

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Abstract

Purpose. To evaluate the peripapillary retinal nerve fiber layer (RNFL) thicknesses of patients treated with intravitreal Ozurdex implant due to branch retinal vein occlusion (BRVO) related macular edema (ME). Methods. Thirty-three eyes of 33 patients treated with Ozurdex implant due to ME associated with BRVO were included in the study. Ophthalmic examinations including determination of best corrected visual acuity (BCVA), measurement of intraocular pressure (IOP), and central macular thickness (CMT) and peripapillary RNFL assessment with optical coherence tomography (OCT) were performed before the injection of Ozurdex implant and during the 6-month follow-up period after the injection. Results. The mean age was 55.2 ± 7.4 (range: 40–68) years. The BCVAs were significantly increased and CMTs were significantly decreased at month 3 and month 6 visits compared to baseline values. The mean IOP was significantly increased from baseline at day 1, week 1, and month 1 visits (p 1 = 0.008, p 2 = 0.018, and p 3 = 0.022, resp.). The average and inferior quadrant peripapillary RNFL thicknesses were significantly reduced at month 6 control visit compared to baseline values (both p < 0.001). Conclusions. Ozurdex implant improved the BCVA and reduced the CMT in the eyes with RVO related ME. However, IOP elevations occurred within the first month after the injection and the average and inferior quadrant RNFL thinning was found six months after the injection. Further controlled studies are warranted.

Highlights

Retinal vein occlusion (RVO) is the most common primary retinal vascular disorder which can involve the central retinal or branch retinal veins [1,2,3]
In the present study, we aimed to evaluate the peripapillary retinal nerve fiber layer (RNFL) thicknesses of patients treated with intravitreal Ozurdex implant due to RVO related Macular edema (ME)
Our results displayed that the best corrected visual acuity (BCVA) significantly increased and the central macular thickness (CMT) significantly decreased in eyes with ME associated with branch retinal vein occlusion (BRVO) during the 6-month follow-up period after intravitreal injection of Ozurdex implant, intraocular pressure (IOP) elevations occurred within the first month after the injection and the average and inferior quadrant RNFL thicknesses were reduced at month 6 control visit

Summary

Introduction

Retinal vein occlusion (RVO) is the most common primary retinal vascular disorder which can involve the central retinal or branch retinal veins [1,2,3]. Macular edema (ME) is the main cause of visual impairment in both branch retinal vein occlusion (BRVO) and central retinal vein occlusion (CRVO) [4]. Several therapies including laser photocoagulation, antivascular endothelial growth factor (anti-VEGF) agents, and triamcinolone have been suggested for the treatment of ME associated with RVO [5]. Ozurdex (Allergan Inc., Irvine, CA, USA), a new sustained-release intravitreal dexamethasone implant, has been demonstrated to be effective in the treatment of patients with RVO related ME [6]. Ozurdex implant lowers the levels of many mediators that cause deterioration of blood-retina barrier, especially VEGF, and decreases the vascular permeability [7]. It has been shown to be associated with intraocular pressure (IOP) elevation [8,9,10,11]

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