Abstract
BackgroundThis study evaluated the effects of dexamethasone intravitreal implant on treatment-naïve branch retinal vein occlusion (BRVO)-induced macular edema (ME), and the risk factors for earlier repeated treatment.MethodsPatients treated from 2013 to 2016 were enrolled. The patients’ demographics, medical history, best-corrected visual acuity (BCVA), and central retinal thickness (CRT) were recorded. Risk factors for repeated treatment were identified using a Cox proportional hazard model and logistic regression.Results29 patients (mean age: 58.64 ± 13.3 years) were included; 44.8% received only one injection, while 55.2% received two or more. The mean initial CRT was 457.8 ± 167.1 μm; the peak CRT and final CRT improved significantly to 248.9 ± 57.9 μm and 329.2 ± 115.1 μm, respectively. The peak BCVA improvement and final improvement were 29.5 ± 23.5 approximate ETDRS letters and 19.8 ± 24.4 letters, respectively, with 62.1% of patients improving by more than 15 letters. Older age, higher initial CRT, and diabetes were the risk factors for multiple injections.ConclusionDexamethasone intravitreal implant results in significant peak CRT and BCVA improvements, while older age, higher initial CRT, and diabetes are risk factors for repeated injections. The optimal retreatment schedule for these patients should be further explored.
Highlights
This study evaluated the effects of dexamethasone intravitreal implant on treatment-naïve branch retinal vein occlusion (BRVO)-induced macular edema (ME), and the risk factors for earlier repeated treatment
Roughly 18– 41% of BRVO-induced ME (BRVO-ME) cases resolve spontaneously over time [2], the extended period of hypoxia resulting from ME can cause irreversible losses of visual acuity even in such cases, while those cases that do not resolve spontaneously can be even more damaging and may call for treatment [1]
Because of the impacts of ME on quality of life (QoL) – one study found that Retinal vein occlusion (RVO)-ME-induced vision loss causes meaningful declines in several aspects of healthrelated QoL [8] – most BRVO-ME patients are willing to undergo invasive treatments in spite of the possibility of spontaneous resolution [9]
Summary
This study evaluated the effects of dexamethasone intravitreal implant on treatment-naïve branch retinal vein occlusion (BRVO)-induced macular edema (ME), and the risk factors for earlier repeated treatment. Retinal vein occlusion (RVO) is second only to diabetic retinopathy in terms of prevalence among retinal vascular disorders and is a major cause of vision loss worldwide [1,2,3,4]. Older age is known to be a major risk factor for the disorder, with a meta-analysis by Rogers et al [2] of RVO in various regions of the world showing a prevalence of only 1.57/1000 among 40- to 49-year-olds versus a prevalence of 12.76/1000 in 70- to 79-year-olds. Branch RVO (BRVO) can result in numerous complications, including macular edema (ME), retinal neovascularization, retinal detachment, and vitreous haemorrhage [1]. Because of the impacts of ME on quality of life (QoL) – one study found that RVO-ME-induced vision loss causes meaningful declines in several aspects of healthrelated QoL [8] – most BRVO-ME patients are willing to undergo invasive treatments in spite of the possibility of spontaneous resolution [9]
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