Follow‐up of IOP and central macular thickness after repeated dexamethasone implants in retinal vein occlusion, about 29 cases

Abstract

AbstractPurpose To investigate the impact of intravitreal dexamethasone implant (ozurdex) on intraocular pressure and on central macular thickness in eyes with macular oedema secondary to retinal vein occlusion.Methods Twenty‐nine patients diagnosed with macular oedema due to retinal vein occlusion (11/29 branch RVO‐18/29 central RVO) and treated with Ozurdex were enrolled in this prospective uncontrolled study. Patients were followed up at 1, 2, 3, 4 and 6 months for IOP (air pulsed tonometer) and central macular thickness (CMT, spectralis SD‐OCT).Results The mean ozurdex injections was 2,4 (1‐5). Most of the patients increased their IOP less than 6mmHg from baseline and were considered as low responder. 27% of patients were « medium responder » and increased their IOP from +6 to 15 mmHg. Only one was a high responder (+19mmHg). OHT occurred during the first (12,5%) or the second month (24%). Two patients has developed OHT only at the second injection (24mmHg). thirty‐one % of patients need a topical hypotensive therapy. The mean initial CMT was 579 μm (+/‐162μm). The mean CMT reduction between M0 and M2 was 282 μm +/‐204μm for the first injection. The anatomic effect was reproducible for the second and the third ozurdex but decreased at the fourth injection (‐196μm). Only two patients had a chronic retinal oedema after two injections.Conclusion OHT has been observed in some patients since M1, so visit at M1 and M2 must be keept to check this point for the first injection. We confirm that very few new patients present OHT during the following injections. Repeated injections of ozurdex provide an effective reduction of the CMT for at least the first three injections. Only one patient was suspected of tachyphylaxis.