David Bellocq1, Jean-François Korobelnik2, Carole Burillon3, Nicolas Voirin4, Corinne Dot5, Eric Souied6, John Conrath7, Solange Milazzo8, Pascale Massin9, Stéphanie Baillif10, Laurent Kodjikian1. 1. Department of Ophthalmology, Croix-Rousse University Hospital, Hospices Civils de Lyon, University of Lyon I, Lyon, France CNRS UMR 5510 Mateis, Villeurbanne, France. 2. Université de Bordeaux, ISPED, Centre INSERM U897-Epidemiologie-Biostatistique, Bordeaux, France INSERM, ISPED, CHUde Bordeaux, France Service d'ophtalmologie, CHUde Bordeaux, France. 3. Department of Ophthalmology, Edouard Herriot Hospital, University of Lyon I, Lyon, France Institut de Biologie et Chimie des Protéines, CNRS/UMR5086, Lyon, France. 4. Service de Biostatistique, Hospices Civils de Lyon, Lyon, France Université de Lyon, Lyon, France Université Lyon 1, Villeurbanne, France CNRS, UMR 5558, Laboratoire de Biométrie et Biologie Evolutive, Equipe Biostatistique-Santé, Villeurbanne, France. 5. Department of Ophthalmology, Desgenettes military Hospital, University of Val de Grâce, Lyon, France. 6. Hopital Intercommunal de Creteil, University Paris Est, Creteil, France. 7. Centre d'Ophtalmologie Monticelli-Paradis, Marseille, France. 8. Department of Ophthalmology, University of Picardie Jules Verne, Clinic Saint Victor, 354, Boulevard of Beauville, Amiens, France Center n° 86 of network EVICR-net. 9. Department of Ophthalmology, Assistance Publique-Hôpitaux de Paris (AP-HP) Université Paris 7, Hôpital Lariboisière, Paris, France. 10. Departement of Ophthalmology, Saint Roch University Hospital, Nice Sophia Antipolis, Nice, France.
Abstract
AIM: To assess the effectiveness and safety of intravitreal dexamethasone implants for treating post-surgical macular oedema, including Irvine-Gass syndrome refractory to first-line treatments. METHODS: Descriptive, observational, retrospective, consecutive, uncontrolled, multicentre, national case series. 50 patients were included in the study between March 2011 and June 2013 with a minimum 6 months follow-up. At baseline, each patient received a dexamethasone implant 0.7 mg (Ozurdex). Best-corrected visual acuity (BCVA), central subfield macular thickness (CSMT), and intraocular pressure (IOP) were measured at baseline and then monthly. The main outcome measure was the mean change in BCVA (in ETDRS letters (Early Treatment Diabetic Retinopathy Study): L) RESULTS: Baseline mean±SD BCVA was 55.7±15.4 L. At month 2, BCVA was 71.8±10.5 L and 61.2% of patients had an increase of more than 15 letters. Baseline mean CSMT was 544±117.2 μm and this decreased to 302 μm at month 2. Anatomic and functional recurrences were both first detected from month 3 and continued throughout follow-up, with values consistently above baseline. The peak in IOP was reached in month 1 with mean IOP of 15.3±4.6 mm Hg. Of the 39/50 patients followed up for 12 months, 49% received a second injection. The anatomic and functional response and safety patterns were similar to that obtained with the first intravitreal injection, demonstrating Ozurdex's reproducibility. However, more than half of the patients followed-up for at least 1 year presented neither functional nor anatomical recurrence. CONCLUSIONS: Ozurdex would appear to be an interesting alternative therapy for treating post-surgical macular oedema, including Irvine-Gass syndrome refractory to first-line treatments. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
AIM: To assess the effectiveness and safety of intravitreal dexamethasone implants for treating post-surgical macular oedema, including Irvine-Gass syndrome refractory to first-line treatments. METHODS: Descriptive, observational, retrospective, consecutive, uncontrolled, multicentre, national case series. 50 patients were included in the study between March 2011 and June 2013 with a minimum 6 months follow-up. At baseline, each patient received a dexamethasone implant 0.7 mg (Ozurdex). Best-corrected visual acuity (BCVA), central subfield macular thickness (CSMT), and intraocular pressure (IOP) were measured at baseline and then monthly. The main outcome measure was the mean change in BCVA (in ETDRS letters (Early Treatment Diabetic Retinopathy Study): L) RESULTS: Baseline mean±SD BCVA was 55.7±15.4 L. At month 2, BCVA was 71.8±10.5 L and 61.2% of patients had an increase of more than 15 letters. Baseline mean CSMT was 544±117.2 μm and this decreased to 302 μm at month 2. Anatomic and functional recurrences were both first detected from month 3 and continued throughout follow-up, with values consistently above baseline. The peak in IOP was reached in month 1 with mean IOP of 15.3±4.6 mm Hg. Of the 39/50 patients followed up for 12 months, 49% received a second injection. The anatomic and functional response and safety patterns were similar to that obtained with the first intravitreal injection, demonstrating Ozurdex's reproducibility. However, more than half of the patients followed-up for at least 1 year presented neither functional nor anatomical recurrence. CONCLUSIONS:Ozurdex would appear to be an interesting alternative therapy for treating post-surgical macular oedema, including Irvine-Gass syndrome refractory to first-line treatments. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
Entities:
Keywords:
Drugs; Inflammation; Macula; Treatment Medical
Authors: Friederike Schaub; Werner Adler; Meike C Koenig; Philip Enders; Rafael S Grajewski; Claus Cursiefen; Ludwig M Heindl Journal: Graefes Arch Clin Exp Ophthalmol Date: 2016-08-24 Impact factor: 3.117