Abstract
To study the treatment patterns, visual outcomes and safety profile of intravitreal dexamethasone implant (IDI) used for the treatment of macular edema secondary to retinal vein occlusion (ME-RVO). Up to 2 years of routinely collected anonymized data within electronic medical record systems were remotely extracted from 16 centers. The outcome measures include visual outcome, number of injections, and safety measures, including the rate of IOP rise, frequency of IOP-lowering medication usage and cataract surgery rates. The study included 688 eyes (44.4%) with central retinal vein occlusion (CRVO) and 862 eyes (55.6%) with branch retinal vein occlusion (BRVO); 1250 eyes (80.6%) were treatment-naïve and 28% (275/989) had high IOP or were on IOP-lowering medications before IDI use. we found that 31% (476) of eyes received 2 injections, 11.7% (182) and 3.7% (58) of eyes received 3 and 4 injections, respectively. The mean baseline Snellen VA improved from 20/125 to 20/40 after the first injection. The probability of cataract surgery was 15% at 24 months. The proportion of eyes with ≥ 10 mmHg change from baseline was higher in phakic (14.2%) compared to pseudophakic eyes (5.4%, p=0.004). Three eyes required IOP filtering surgery (0.2%). The visual results of IDI in eyes with ME-RVO in the real world are comparable to the clinical trial setting. Increased IOP in eyes with pre-existing ocular hypertension or glaucoma can be controlled with additional medical treatment. IOP rise with IDI may be more frequent in phakic than pseudophakic eyes.
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