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Effectiveness and safety of dexamethasone implants for post-surgical macular oedema including Irvine-Gass syndrome: the EPISODIC study
  1. David Bellocq1,2,
  2. Jean-François Korobelnik3,4,5,
  3. Carole Burillon6,7,
  4. Nicolas Voirin8,9,10,11,
  5. Corinne Dot12,
  6. Eric Souied13,
  7. John Conrath14,
  8. Solange Milazzo15,16,
  9. Pascale Massin17,
  10. Stéphanie Baillif18,
  11. Laurent Kodjikian1,2
  1. 1Department of Ophthalmology, Croix-Rousse University Hospital, Hospices Civils de Lyon, University of Lyon I, Lyon, France
  2. 2CNRS UMR 5510 Mateis, Villeurbanne, France
  3. 3Université de Bordeaux, ISPED, Centre INSERM U897-Epidemiologie-Biostatistique, Bordeaux, France
  4. 4INSERM, ISPED, CHUde Bordeaux, France
  5. 5Service d'ophtalmologie, CHUde Bordeaux, France
  6. 6Department of Ophthalmology, Edouard Herriot Hospital, University of Lyon I, Lyon, France
  7. 7Institut de Biologie et Chimie des Protéines, CNRS/UMR5086, Lyon, France
  8. 8Service de Biostatistique, Hospices Civils de Lyon, Lyon, France
  9. 9Université de Lyon, Lyon, France
  10. 10Université Lyon 1, Villeurbanne, France
  11. 11CNRS, UMR 5558, Laboratoire de Biométrie et Biologie Evolutive, Equipe Biostatistique-Santé, Villeurbanne, France
  12. 12Department of Ophthalmology, Desgenettes military Hospital, University of Val de Grâce, Lyon, France
  13. 13Hopital Intercommunal de Creteil, University Paris Est, Creteil, France
  14. 14Centre d'Ophtalmologie Monticelli-Paradis, Marseille, France
  15. 15Department of Ophthalmology, University of Picardie Jules Verne, Clinic Saint Victor, 354, Boulevard of Beauville, Amiens, France
  16. 16Center n° 86 of network EVICR-net
  17. 17Department of Ophthalmology, Assistance Publique—Hôpitaux de Paris (AP-HP) Université Paris 7, Hôpital Lariboisière, Paris, France
  18. 18Departement of Ophthalmology, Saint Roch University Hospital, Nice Sophia Antipolis, Nice, France
  1. Correspondence to Professeur Laurent Kodjikian, Service d'Ophtalmologie, Hôpital de la Croix-Rousse, 103 Grande Rue de la Croix Rousse, 69317 LYON Cedex 04, France; kodjikian.laurent{at}wanadoo.fr

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.

  • Drugs
  • Inflammation
  • Macula
  • Treatment Medical

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