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Br J Ophthalmol. 2019 Apr;103(4):463-468. doi: 10.1136/bjophthalmol-2017-311805. Epub 2018 Jun 11.

Long-term visual outcome and its predictors in macular oedema secondary to retinal vein occlusion treated with dexamethasone implant.

Author information

1
Department of Ophthalmology, University Hospital Leipzig, Leipzig, Germany.
2
Banker's Retina Clinic & Laser Center, Ahmedabad, India.
3
Division of Ophthalmology, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
4
Private Retina Office, University of Buenos Aires, Buenos Aires, Argentina.
5
Department of Ophthalmology and Visual Sciences, Federal University of Sao Paulo, Sao Paulo, Brazil.
6
Eye Clinic - Department of Biomedical and Clinical Science 'L. Sacco', Luigi Sacco Hospital, University of Milan, Milan, Italy.
7
Save Sight Institute , University of Sydney, Sydney, NSW, Australia.
8
Department of Clinical Sciences and Community Health, University of Milan, Ophthalmological Unit, IRCCS-Cà Granda Foundation - Ospedale Maggiore Policlinico, Milan, Italy.
9
L.V. Prasad Eye Institute, Banjara Hills, Hyderabad, India.
10
Department of Ophthalmology, Faculty of Medicine, Srinagarind Hospital, Khon Kaen University, Khon Kaen, Thailand.
11
Service d'Ophtalmologie, Hôspital Lariboisière, Université Paris, Sorbonne Paris Cité, Paris, France.
12
ICARE Eye Hospital and Postgraduate Institute, Noida, India.
13
Retina Foundation and Eye Research Center, Ahmedabad, India.
14
Post Graduate Institute of Medical Education and Research, Chandigarh, India.
15
Royal Victorian Eye and Ear Hospital, Melbourne, Victoria, Australia.
16
Dokuz Eylul University, İzmir, Turkey.
17
Department of Ophthalmology, American University of Beirut, Beirut, Lebanon.
18
Department of Ophthalmology, Rafic Hariri University Hospital, Beirut, Lebanon.
19
L.V. Prasad Eye Institute, Banjara Hills, Hyderabad, India jay.chhablani@gmail.com.

Abstract

BACKGROUND:

To evaluate the functional long-term outcome in patients with macular oedema (MO) secondary to central retinal vein occlusion (CRVO) and branch retinal vein occlusion (BRVO) treated with dexamethasone implant (DEX implant) and to identify its clinical predictors.

METHODS:

A 24-month, retrospective, multinational, real-world study. Chart review of patients with either naïve or recurrent MO secondary to CRVO/BRVO treated with DEX implant, including best-corrected visual acuity (BCVA), central subfield thickness (CST), demographic baseline characteristics and details of any additional treatment during follow-up.

RESULTS:

A total of 155 eyes (65 CRVO, 90 BRVO) from 155 patients were included. At 24 months, mean BCVA did not change significantly in CRVO (-2.1±24.5 letters, p=0.96) and BRVO patients (1.3±27.0 letters, p=0.07). A worse baseline BCVA (p<0.001), visual acuity (VA) gain ≥5 letters at 2 months (p=0.006) and no need for adjunctive intravitreal therapy after first DEX implant (p=0.001) were associated with a better final BCVA gain. Treatment-naïve patients (p=0.006, OR: 0.25, 95% CI 0.11 to 0.57) and those with a baseline CST≤400 µm (p=0.02, OR: 0.25, 95% CI 0.10 to 0.63) were identified as being less likely to need additional intravitreal therapy.

CONCLUSION:

Clinical baseline characteristics and the early treatment response were identified as possible predictors for long-term outcome and the need of adjunctive intravitreal therapy in MO secondary to BRVO/CRVO treated by DEX implant.

KEYWORDS:

Long-term outcome

Conflict of interest statement

Competing interests: None declared.

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