Safety and long-Term Outcomes of Repeated Dexamethasone Intravitreal Implant (OZURDEX®) for the Management of Macular Edema

Abstract

Purpose: This study to assess the efficacy and the safety of repeated dexamethasone intravitreal implant (Ozurdex®) in vascular macular edema in real-life practice. Materials and Methods: This was a 22-month prospective study, including eyes with vascular macular edema according to the inclusion criteria. Baseline and follow-up visits included best-corrected visual acuity (BCVA) measurement, slit-lamp biomicroscopy, dilated fundoscopy, intraocular pressure (IOP) measurement, and central macular thickness (CMT) measurement with optical coherence tomography. Main outcomes included changes in BCVA and CMT at the 1st, 2nd, 4th, and 6th months; time to retreatment; and incidence of side effects. Results: A total of 31 eyes of 24 patients were included in the present study. After the first intravitreal injection, BCVA (baseline 0.940 ± 0.463 LogMAR) improved significantly to 0.483 ± 0.323 LogMAR at 2nd month (P = 0.000), 0.657 ± 0.357 at 4th month (P = 0.000), and 0.690 ± 0,448 at 6th month (P = 0.001). Mean CMT (baseline = 582.51 ± 148.20) decreased statistically significantly at 2nd month and 4th month after the first intravitreal injection (245.87 ± 103.86 and 456.68 ± 182.735, respectively, both P < 0.001 vs. baseline). At the 6th month, CMT was 407.93 ± 212.70 for the 16 eyes that had not been reinjected versus baseline CMT 576.93 ± 158.56 (P = 0.008). After other Ozurdex® injections, we had the same visual acuity gain and CMT reduction, an average of 2.03 ± 0.83 injections were done. The most common side effects were cataract development and rise in IOP. Conclusion: Ozurdex® implant is an effective treatment for vascular macular edema with a good safety profile; however, its effectiveness seems to decrease with time requiring repeated injections.