Recurrence Of Macular Edema Research Articles

Intravitreal Pharmacotherapy for the Treatment of Macular Edema Secondary to Branch Retinal Vein Occlusion: A Narrative Review

Branch retinal vein occlusion (BRVO) is the next most common retinal vascular disorder following diabetic retinopathy, and macular edema is the most frequent cause of visual impairment in patients with BRVO. For many years, grid laser photocoagulation was the standard of care for the treatment of BRVO-associated macular edema. Grid laser photocoagulation was used for patients with macular edema secondary to BRVO longer than 3 months and visual acuity less than 20/40. Currently increasing data supports the effect of anti-vascular endothelial growth factors in the treatment of BRVO-associated macular edema. Recent studies have shown that intravitreal bevacizumab injection is a safe and effective modality for the treatment of BRVO-associated macular edema; however, the recurrence of macular edema is common following an intravitreal bevacizumab injection. Other anti-vascular endothelial growth factor (VEGF) agents such as ranibizumab, pegaptanib, and aflibercept are effective options. Combining anti-VEGFS with grid laser may be effective in refractory cases and also may prolong the interval between intravitreal injections. Switching to a different anti-VEGF or dexamethasone implant may be effective in the treatment of refractory cases; however, the efficacy of an intravitreal dexamethasone implant may diminish after a few months, and elevated intraocular pressure and cataract formation may occur.

Six-month postoperative outcomes of intraoperative OCT-guided surgical cystotomy for refractory cystoid macular edema in diabetic eyes.

PurposeThis study evaluated the outcomes of surgical cystotomy for recurrent diabetic cystoid macular edema (CME).Patients and methodsWe analyzed 20 eyes with a clinical diagnosis of diabetic retinopathy and refractory CME. Release of vitreoretinal adhesion, epiretinal membrane (ERM) and internal limiting membrane (ILM) peeling and cystotomy guided by intraoperative optical coherence tomography (iOCT) were performed in every patient. Pars plana vitrectomy was also performed in 17 patients, 11 of whom also underwent lensectomy and intraocular lens implantation. Central retinal thickness (CRT), central minimum macular thickness (CMMT), macular volume (MV) and best-corrected visual acuity (BCVA) were compared preoperatively and 1 and 6 months post surgery.ResultsCRT, CMMT and MV significantly improved 1 and 6 months post surgery in each group (P<0.01). Significant improvements in BCVA were only observed 6 months post surgery (P<0.01). No intra- or postoperative complications were observed in all patients.ConclusionCRT, CMMT, MV and BCVA significantly improved 6 months following surgical cystectomy. This implies that iOCT-guided cystotomy could be another treatment option for refractory CME in diabetic eyes.

Aflibercept for Previously Treated Macular Edema Associated with Central Retinal Vein Occlusions: 1-Year Results of the NEWTON Study

To determine whether aflibercept (Eylea; Regeneron Pharmaceuticals, Tarrytown, NY) can extend the macular edema-free interval in patients with nonischemic central retinal vein occlusions (CRVOs) previously treated with ranibizumab (Lucentis; Genentech, South San Francisco, CA) or bevacizumab (Avastin; Genentech, South San Francisco, CA). Prospective, single-arm, interventional study. Twenty patients with chronic nonischemic CRVOs. Patients with nonischemic CRVOs previously treated with ranibizumab or bevacizumab were switched to aflibercept. The inclusion criteria included treatment for ≥6 months with ≥3 initial loading doses and evidence of recurrence of edema when treatment with either ranibizumab or bevacizumab extended beyond 4weeks. Intravitreal aflibercept was administered with a treat-and-extend dosing regimen. Injection frequencies were extended 2 weeks if there were no signs of disease activity on OCT or change in visual acuity. Macular edema-free interval at week52. Twenty patients had an average duration of a CRVO for 22 months (range, 7-90 months) and averaged an anti-vascular endothelial growth factor (anti-VEGF) treatment every 42 days (range, 28-60 days). These patients received a mean of 15 treatments (range, 5-47 treatments) of ranibizumab or bevacizumab for macular edema secondary to nonischemic CRVO. Among the 17 patients who completed 1 year of follow-up, 94% had a greater macular edema-free interval with aflibercept treatment. The macular edema-free interval increased from 5.4 weeks to 9.1 weeks when treatment was switched to aflibercept (P= 0.000003). There was an average increase of 26 days (range, 0-63 days) in the macular edema free interval with aflibercept. There was an improvement in vision (+6 Early Treatment Diabetic Retinopathy Study letters, P= 0.02) and decreased retinal thickness (152 μm, P= 0.0002) with aflibercept treatment. In patients previously treated with ranibizumab or bevacizumab for macular edema due to nonischemic CRVO, aflibercept increased the macular edema free interval. This may help minimize the treatment burden in patients with recurrent macular edema secondary to nonischemic CRVO.

Short-term results of endovascular surgery with tissue plasminogen activator injection for central retinal vein occlusion.

To examine the effects of retinal endovascular surgery (REVS) with tissue plasminogen activator injection into the retinal vein in central retinal vein occlusion (CRVO) eyes. Sixteen consecutive CRVO patients with macular edema and decreased visual acuity who were referred to Toyama University Hospital between March 2014 and February 2016 were included in this study. Changes in visual acuity (VA) and central retinal thickness (CRT) were evaluated up to 6months after REVS. Staining and leakage of the retinal veins in fluorescein angiography (FA) was graded in nine patients. Ten of 16 eyes were determined to be non-ischemic while the remaining six were ischemic. The mean logarithm of the minimum angle of resolution (logMAR) of VA was significantly improved from 0.98±0.58 (mean±standard deviation) at baseline to 0.78±0.61 at 3months (p=0.002), and 0.64±0.60 at 6months (p=0.003) after REVS. At 6 months, VA was improved in eight eyes (50%), while the other eight (50%) showed no change; none showed worsening. In the 10 eyes with non-ischemic CRVO, the mean VA was significantly improved at 6months (p=0.002), whereas no improvement was found in the six eyes with ischemic CRVO, . In all eyes, the mean CRT was significantly improved from 804±343μm at baseline to 506±304μm at 2months (p=0.014), 332±229μm at 3months (p=0.0001), and 305±235μm at 6months (p=0.00001). The postoperative complications observed were prolonged vitreous hemorrhage in one eye and neovascular glaucoma in two eyes. For postoperative recurrence of macular edema, sub-tenon injection of triamcinolone acetonide was given to five eyes, and intravitreal injection of an anti-VEGF agent was given to five eyes. Pan-retinal photocoagulation was performed on six eyes with ischemic type CRVO. The FA score was significantly improved after REVS (p=0.018). REVS using a specially made micro-needle may be a surgical treatment option for non-ischemic CRVO, but it did not seem effective for ischemic CRVO.

Early Response to Ranibizumab Is Associated with 12-Month Outcome in Diabetic Macular Edema after Prior Macular Laser Therapy

Purpose: To evaluate the efficacy of ranibizumab in persistent or recurrent diabetic macular edema (DME) after previous laser therapy. Methods: This prospective, interventional study consisted of a 3-month period of scheduled ranibizumab treatment followed by a 9-month period of pro re nata treatment. Results: A total of 21 eyes (18 patients) were included. Both best corrected visual acuity and central retinal thickness had statistically significantly improved from baseline at month 12 (p < 0.001). The mean number of injections within these 12 months was 7.8 ± 2.6 (range 3-11). The visual change at month 12 did not vary by more than 5 letters from the response observed at week 12. Conclusions: Our study showed a beneficial effect from ranibizumab in DME patients previously treated with macular laser therapy. The response at week 12 was sustained up to 1 year. A suboptimal early visual response may predict a long-term suboptimal response and help identify patients who would benefit from an alternative regimen.

Radiation maculopathy treated with intravitreal bevacizumab

Abstract Case report A 47 year-old woman with a choroidal melanoma developed a macular edema secondary to radiation therapy 75 months after brachytherapy plaque. The patient received 3 intravitreal Bevacizumab injections. Discussion The patient had a good response to bevacizumab treatment. In fact, there was a reduction in the macular edema measured by optical coherence tomography (OCT) scan, as well as an improvement in best corrected visual acuity. There was no recurrence of macular edema, and visual acuity remained stable after 3-years follow-up.

Clinical Features and Incidence Rates of Ocular Complications in Patients With Retinal Vasculitis

To describe the incidence rates of visual loss and ocular complications in patients with retinal vasculitis (RV). Retrospective cohort study. Clinical data were collected for 96 patients (175 eyes) diagnosed with RV from 2003 to 2013. Main outcome measures included rates of visual loss and ocular complications. Comparison of outcomes in patients with a relapsing vs nonrelapsing disease also were analyzed. Over a median follow-up of 44months (range: 1-153months), the rate of visual loss to 20/50 or worse was 0.13 per eye-year (/EY, 95% confidence interval [CI], 0.09/EY to 0.18/EY) and to 20/200 or worse was 0.06/EY (95% CI, 0.04/EY to 0.08/EY). The most common complications were cataract (0.31/EY), epiretinal membrane (0.16/EY), and recurrent macular edema (0.09/EY). Patients with a relapsing course (median number of relapses= 1, range: 1-6) appeared to have greater risk for visual loss to 20/50 (odds ratio [OR]= 2.07; 95% CI, 0.88-4.90, P=.09) and 20/200 or worse (OR= 2.49; 95% CI, 0.98-6.30, P= .05). Immunosuppressive drug therapy lowered the risk of visual loss, independent of relapsing disease course (OR= 0.79; 95% CI, 0.66-0.94, P=.01 and OR= 0.73; 95% CI, 0.57-0.93, P=.01 for the 20/50 or worse and 20/200 or worse thresholds, respectively). Rates of visual loss and complications among patients with RV were similar to reported rates in noninfectious uveitides. Treatment with immunosuppressive drugs lowered the risk of visual loss. A relapsing course suggested an increased risk for visual loss but was not statistically significant, perhaps owing to low numbersof recurrences.

Short-term outcomes in patients with branch retinal vein occlusion who received intravitreal aflibercept with or without intravitreal ranibizumab.

PurposeThe purpose of this study was to determine the short-term outcomes for patients who received intravitreal aflibercept (IVA) with or without intravitreal ranibizumab (IVR) for macular edema (ME) due to branch retinal vein occlusion (BRVO).Patients and methodsPatients received IVA for ME due to BRVO. Patients who initially received IVA were defined as the treatment-naïve group and those who were switched from IVR to IVA after ME recurrence were defined as the switching group. Patient outcomes were examined at 1 week and 1 month postinjection.ResultsBoth groups comprised 27 eyes from 27 patients. There was a significant decrease in central macular thickness (CMT) at 1 week and 1 month postinjection in both groups. There was also a significant improvement in best-corrected visual acuity (BCVA) at 1 week and 1 month postinjection in the treatment-naïve group and 1 month in the switching group. Younger age was associated with a good BCVA at 1 month postinjection in the switching group, and the absence of epiretinal membrane was associated with a reduction in CMT at 1 month postinjection in the switching group.ConclusionIVA is temporarily effective for treating ME due to BRVO regardless of a history of IVR use.

Fuchs’ dystrophy associated with radial keratotomy: Lamellar or perforating keratoplasty?

Abstract Case report A 70 year-old male patient with a history of radial keratotomy suffering from Fuchs’ dystrophy and a cataract. The patient received a two-step surgery: lens phacoemulsification and intraocular lens implant, followed by descemet stripping automated endothelial keratoplasty in both eyes, four months later. There were no complications apart from a recurrent cystoid macular edema in both eyes. The best corrected visual acuity was 20/40 both eyes, and the patient was satisfied. Discussion Descemet stripping automated endothelial keratoplasty may be considered as an alternative to penetrating keratoplasty in the case of endothelial dysfunction and radial keratotomy in patients with no corneal ectasia or significant stromal opacity.

Macular cystic changes as predictive factor for the recurrence of macular oedema in branch retinal vein occlusion.

To evaluate the role of small cystic macular changes as a prognostic factor for the recurrence of macular oedema (ME) in patients with branch retinal vein occlusion (BRVO) treated with anti-VEGF drugs. We performed retrospective chart analysis of 116 patients treated with intravitreal injection of ranibizumab (IVR) or bevacizumab (IVB) for ME secondary to BRVO. At the baseline and monthly follow-up visits over a period of 12months, a comprehensive ophthalmologic examination including best-corrected visual acuity (BCVA) and volume scan of macula using Spectral domain optical coherence tomography (SD-OCT) were performed. Patients without ME (CRT <250μm) were screened for the presence of intraretinal cysts. In these patients, the changes in BCVA and CRT were evaluated over a period of 12months and compared with the baseline. In the IVR group (41 patients), 91 events of macular cysts, without a worsening of BCVA, were detected by OCT. In 89 of 91 events (97%), BCVA and CRT deteriorated significantly (p<0.0001) within the next 4-11 (in mean 7.1±2.0) weeks. BCVA decreased from 0.38±0.25 to 0.49±0.27 logMAR and CRT increased significantly from 223±43 to 605±244μm. In the IVB group (19 patients), 54 events of cystic changes were detected. All of these patients showed significant worsening of BCVA from 0.40±0.19 to 0.57±0.22 logMAR and CRT from 251±17 to 490±147μm within 4-10 (in mean 7.8±2.8) weeks after the first presence of small macular cysts. In BRVO patients treated with anti-VEGF drugs, the macular cystic changes may be used as an early indicator for impending recurrence of ME, with the decrease in BCVA in the following weeks. These patients should be scheduled for a next visit within 6-8weeks.

Risk factors of recurrence of macular oedema associated with branch retinal vein occlusion after intravitreal bevacizumab injection

Background/aimsTo identify risk factors of recurrence of macular oedema in branch retinal vein occlusion (BRVO) after intravitreal bevacizumab (IVB) injection.MethodsThe records of 63 patients who underwent IVB injection for macular...

Natural Short-term Course of Recurrent Macular Edema Following Intravitreal Bevacizumab Therapy in Branch Retinal Vein Occlusion.

PurposeTo evaluate the 3-month natural course of recurrent macular edema secondary to branch retinal vein occlusion (BRVO) treated with intravitreal bevacizumab.MethodsThis retrospective, observational study included 36 eyes with macular edema secondary to BRVO. All patients were initially treated with intravitreal bevacizumab for macular edema. Recurrence of macular edema was either not treated (untreated group) or treated with a single intravitreal bevacizumab injection (treated group). Central foveal thickness (CFT) and best-corrected visual acuity (BCVA) were compared at the time of recurrence and 3 months later.ResultsAt the time of recurrence, the mean CFT and logarithm of the minimum angle of resolution BCVA were 484.9 ± 124.1 µm and 0.58 ± 0.26 in the untreated group (n = 19) and 456.3 ± 126.8 µm and 0.51 ± 0.21 in the treated group (n = 17), respectively. Three months later, the mean CFT and BCVA had changed to 493.7 ± 123.9 µm and 0.62 ± 0.29 in the untreated group and 294.7 ± 104.4 µm and 0.40 ± 0.24 in the treated group, respectively. The differences in CFT and BCVA between the two time points were not significant in the untreated group (p = 0.106 and p = 0.687, respectively), whereas statistically significant differences were noted in the treated group (p = 0.002 and p < 0.001, respectively).ConclusionsUnlike the first episode of macular edema following BRVO, recurrent macular edema following intravitreal bevacizumab therapy did not spontaneously resolve, suggesting the potential benefit of prompt treatment.

Distrofia de Fuchs asociada a queratotomía radial: ¿queratoplastia penetrante o lamelar?

Case reportA 70 year-old male patient with a history of radial keratotomy suffering from Fuchs' dystrophy and a cataract. The patient received a two-step surgery: lens phacoemulsification and intraocular lens implant, followed by descemet stripping automated endothelial keratoplasty in both eyes, four months later. There were no complications apart from a recurrent cystoid macular oedema in both eyes. The best corrected visual acuity was 20/40 both eyes, and the patient was satisfied. DiscussionDescemet stripping automated endothelial keratoplasty may be considered as an alternative to penetrating keratoplasty in the case of endothelial dysfunction and radial keratotomy in patients with no corneal ectasia or significant stromal opacity.

Bevacizumab intravítreo en el tratamiento de la maculopatía por radiación

Case reportA 47 year-old woman with a choroidal melanoma developed a macular oedema secondary to radiation therapy 75 months after brachytherapy plaque. The patient received 3 intravitreal Bevacizumab injections. DiscussionThe patient had a good response to bevacizumab treatment. In fact, there was a reduction in the macular oedema measured by optical coherence tomography (OCT) scan, as well as an improvement in best corrected visual acuity. There was no recurrence of macular oedema, and visual acuity remained stable after 3-years follow-up.

Intravitreal dexamethasone implant for recurrent cystoid macular edema due to Irvine-Gass syndrome: a prospective case series.

PurposeTo determine the preliminary efficacy and safety of off-label dexamethasone implant for treatment of recurrent cystoid macular edema (CME) secondary to Irvine-Gass syndrome (IGS).Patients and methodsThis study was set in Raghudeep Eye Clinic, Ahmedabad and LV Prasad Eye Institute, Hyderabad (India). It is a Prospective Case Series. Prospective case series comprising of patients with uncomplicated pseudophakia and CME due to IGS who recurred after one course of topical steroids with NSAIDS and a sub-Tenon corticosteroid injection. A complete ocular and systemic exam, fluorescein angiography, and central subfield thickness (CST) on optical coherence tomography scans were performed. Follow-up visits were on days 1, 15, and 30 and then monthly for a year. Appropriate statistical analysis was done. The primary outcome measure was the change in CDVA at months 1, 6, and 12. Secondary outcome measures were recurrence of CME and complications if any as noted at months 1, 2, 6, and 12.ResultsAbout 27 patients (27 eyes) with 16 males were included. Median age: 63.24±5.62 years. At 1 month, the CDVA improved to 0.04±0.02 (20/25) logMAR from 0.52±0.12 logMAR (20/70) (P=0.001) with a reduction in CST from 454.2±45.3 to 218.32±38.15 microns(P=0.013). The CDVA was 0.04±0.03 logMAR(P<0.001) at month 6 and 0.05±0.02 logMAR(P<0.001) at month 12. The CST was 221±35.2 microns (P=0.013) at month 6 and 214±43.34 microns (P=0.0124) at month 12. All improvements were maintained for a year. Only one patient required a second injection. No complications were noted.ConclusionThe implant is safe and effective for the treatment of recurrent CME due to IGS.

Cytokines and Recurrence of Macular Edema after Intravitreal Ranibizumab in Patients with Branch Retinal Vein Occlusion

The aqueous humor levels of cytokines and growth/inflammatory factors were measured in 46 branch retinal vein occlusion (BRVO) patients with macular edema (ME) who were treated with intravitreal ranibizumab injection (IRI). Patients with recurrence of ME received further IRI as needed. The number of IRIs was significantly correlated with age, baseline best-corrected visual acuity, and baseline central macular thickness (CMT), as well as the baseline aqueous levels of 5 cytokines/factors (soluble vascular endothelial growth factor receptor-1, platelet-derived growth factor-AA [PDGF-AA], soluble intercellular adhesion molecule-1, interleukin-6 [IL-6], and IL-8). Multivariate linear regression analysis with stepwise selection confirmed that age, baseline CMT, and baseline PDGF-AA level were independent determinants of the number of IRIs. These findings suggest that inflammatory factors may influence the recurrence of ME in BRVO patients, and that PDGF-AA might be a useful indicator of the number of IRIs required to control ME.

Management strategies in vasoactive proliferative tumor of the retina

PurposeVasoactive proliferative tumor of the retina is extremely rare in children. Our purpose is to report the clical characteristics and management stratregy in this rare tumor of the retina.MethodsCase Report.ResultsA 12 years‐old female was presented with decreased vision on her left eye. The vision was 20/20 on OD and counting fingers at 1 m on OS. There was marked retinal edema and exudation at presentation. Full systemic evaluation was performed without any evidence of systemic disease. There was also no other ocular disease. On fundus examination there was telenigectatic vessels adjasent to peripapillary retina. Previous attempts of intravitreal antiVEGF bevacizumab injections elsewhere did not improve the vision and macular edema. The patient had marked retinal fluid at presentation and we decided to try intravitreal dexamethasone implant (Ozurdex) in treatment. The vision improved significantly right after the treatment but the patient developed cataract after two Ozurdex applications. After phacoemulsification with IOL implantation we were able to apply laser photocoagulation as the retinal fluid is resolved significantly and the vision improved to 20/40 after three Ozurdex applications.ConclusionsVasoactive proliferative tumor is extremely rare in children. Our case indicates that intravitreal dexamethasone implant (Ozurdex) is effective in resolution of subretinal fluid in such cases and this treatment modality gives a window to apply destructive laser over the lesion to prevent recurrences of macular edema.

Clinical Characteristics and Treatment Outcomes of Recurrent Central Retinal Vein Occlusions

ABSTRACTPurpose: To report the ocular findings, systemic hematologic parameters, and treatment outcomes of patients with recurrent central retinal vein occlusions (CRVO). Methods: A retrospective analysis of eyes that developed recurrent CRVO was performed. Key exclusion criteria were follow-up of less than six months after the recurrence, incomplete documentation, and recurrent macular edema in an eye with a CRVO but without evidence of increased superficial hemorrhage or disc edema (recurrent CRVO). Collected data included demographic information, history of presenting illness including the previous CRVO, ocular and systemic co-morbidities, and clinical examination findings that included visual acuities and imaging details from the time of initial CRVO diagnosis until the final examination. Results: Thirteen eyes of 12 subjects with recurrent CRVO were evaluated. The mean age of the patients was 63 years (range: 42 to 79 years). The mean interval between treatment of the initial CRVO and the onset of the recurrent CRVO was 9.0 ± 9.3 months. The visual acuity declined by approximately eight lines at the time of recurrence. Treatment with vascular endothelial growth factor inhibitors and corticosteroids significantly improved mean central macular thickness (CMT) from the time of recurrence until the final examination (808 ± 169 vs. 511 ± 302 µm; P = 0.004), but failed to change visual acuity (1.28 ± 0.31 logMAR vs. 1.24 ± 0.43 logMAR; P = 0.8). No uncontrolled systemic risk factors were associated with recurrences. Conclusion: Recurrent CRVO in the same eye occurs infrequently and may not be associated with an uncontrolled systemic disease. Despite multimodal therapy, most eyes do not recover vision to the pre-recurrence level.

Intravitreal ziv-aflibercept for macular edema following retinal vein occlusion.

AimTo report the efficacy of intravitreal ziv-aflibercept injections in eyes with macular edema due to retinal vein occlusions (RVOs).MethodsConsecutive patients with persistent or recurrent macular edema (central macula thickness >250 μm) due to RVO were enrolled in this prospective study. Study eyes received intravitreal injections of ziv-aflibercept (1.25 mg/0.05 mL) at baseline. Patients were reassessed monthly for 4 months and given additional injections pro re nata for worsening best-corrected visual acuity (BCVA), intraretinal edema or subretinal fluid seen on spectral domain optical coherence tomography, or central macular thickness (CMT) measurements >250 μm. The primary endpoint was improvement in mean CMT at 4 months. Secondary endpoints included improvement in mean BCVA, and ocular and systemic safety signals.ResultsNine eyes (five central and four branch RVOs) of nine patients were enrolled. The mean ± standard deviation CMT decreased from 604±199 μm at baseline to 319±115 μm (P=0.001) at 1 month and to 351±205 μm (P=0.026) at 4 months. The mean BCVA did not improve significantly from baseline (1.00 LogMAR) to the 1-month (0.74 LogMAR; P=0.2) and 4-month (0.71 LogMAR; P=0.13) visits. No safety signals were noted.ConclusionIn this small prospective study, intravitreal ziv-aflibercept significantly improved mean CMT in eyes with persistent or recurrent macular edema due to RVOs. Prospective, randomized trials comparing ziv-aflibercept with standard pharmacotherapy are needed to better define efficacy and safety.

Effect of intravitreal dexamethasone implant on intra-ocular cytokines and chemokines in eyes with retinal vein occlusion.

To investigate the influence of intravitreal dexamethasone implant on inflammatory and angiogenic cytokine levels in the aqueous of patients with retinal vein occlusion (RVO). Forty eyes of 40 consecutive patients with macular oedema (ME) due to branch and central retinal vein occlusion (BRVO/CRVO) were treated with an intravitreal dexamethasone implant (Ozurdex® ) at baseline and evaluated until month 6. Retreatment was performed in case of recurrent ME earliest 4months after the baseline treatment. Aqueous humour samples were taken at baseline, months 1, 3, 6 and at the time of each retreatment. Concentrations of 29 different cytokines were measured by Luminex® bead assays. The control group comprised healthy patients undergoing cataract surgery. At baseline concentrations of interleukin (IL)-8, angiopoietin (ANG)-2 and intercellular adhesion molecule (ICAM)-1 were highly elevated in patients with CRVO compared with controls (p=0.006; p=0.02; p=0.03). Vascular endothelial growth factor (VEGF) concentrations were upregulated in patients with BRVO and CRVO (p=0.003; p=0.001). Retreatment with a dexamethasone implant was necessary after 4months in 14/8 (BRVO/CRVO) patients, 5months in 5/3 patients and 6months in one patient (BRVO). After the initial treatment, macrophage chemo-attractant protein (MCP)-1 and IL17-E concentrations decreased in BRVO (p<0.001; p=0.01) and MCP-1 and IL1-α in CRVO (p=0.01; p=0.003). Vascular endothelial growth factor (VEGF) concentrations did not change during treatment in either group (p=0.3). A mixed-effect model showed that cytokine concentrations positively correlated with central retinal thickness changes. Intravitreal dexamethasone treatment resulted in alterations in the concentrations of pro-inflammatory cytokines MCP-1 and IL17-E in patients with BRVO and MCP-1 and IL1-α in patients with CRVO. These data highlight the important role of inflammatory mediators involved in ME due to RVO.