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

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Clinical science
Long-term visual outcome and its predictors in macular oedema secondary to retinal vein occlusion treated with dexamethasone implant
  1. Catharina Busch1,
  2. Matus Rehak1,
  3. Chintan Sarvariya2,
  4. Dinah Zur3,
  5. Matias Iglicki4,
  6. Luiz H Lima5,
  7. Alessandro Invernizzi6,7,
  8. Francesco Viola8,
  9. Kushal Agrawal9,
  10. Suthasinee Sinawat10,
  11. Aude Couturier11,
  12. Aanchal Mehta12,
  13. Rakesh Juneja13,
  14. Hardik Jain13,
  15. Aniruddha Kishandutt Agarwal14,
  16. Neha Goel12,
  17. Manish Nagpal13,
  18. Vishali Gupta14,
  19. Alay Banker2,
  20. Anat Loewenstein3,
  21. Mali Okada15,
  22. Ali Osman Saatci16,
  23. Ahmad M Mansour17,18,
  24. Jay Chhablani9
  1. 1 Department of Ophthalmology, University Hospital Leipzig, Leipzig, Germany
  2. 2 Banker's Retina Clinic & Laser Center, Ahmedabad, India
  3. 3 Division of Ophthalmology, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
  4. 4 Private Retina Office, University of Buenos Aires, Buenos Aires, Argentina
  5. 5 Department of Ophthalmology and Visual Sciences, Federal University of Sao Paulo, Sao Paulo, Brazil
  6. 6 Eye Clinic - Department of Biomedical and Clinical Science ‘L. Sacco’, Luigi Sacco Hospital, University of Milan, Milan, Italy
  7. 7 Save Sight Institute , University of Sydney, Sydney, NSW, Australia
  8. 8 Department of Clinical Sciences and Community Health, University of Milan, Ophthalmological Unit, IRCCS-Cà Granda Foundation – Ospedale Maggiore Policlinico, Milan, Italy
  9. 9 L.V. Prasad Eye Institute, Banjara Hills, Hyderabad, India
  10. 10 Department of Ophthalmology, Faculty of Medicine, Srinagarind Hospital, Khon Kaen University, Khon Kaen, Thailand
  11. 11 Service d'Ophtalmologie, Hôspital Lariboisière, Université Paris, Sorbonne Paris Cité, Paris, France
  12. 12 ICARE Eye Hospital and Postgraduate Institute, Noida, India
  13. 13 Retina Foundation and Eye Research Center, Ahmedabad, India
  14. 14 Post Graduate Institute of Medical Education and Research, Chandigarh, India
  15. 15 Royal Victorian Eye and Ear Hospital, Melbourne, Victoria, Australia
  16. 16 Dokuz Eylul University, İzmir, Turkey
  17. 17 Department of Ophthalmology, American University of Beirut, Beirut, Lebanon
  18. 18 Department of Ophthalmology, Rafic Hariri University Hospital, Beirut, Lebanon
  1. Correspondence to Dr Jay Chhablani, L.V. Prasad Eye Institute, Hyderabad, Telangana 500034, India; jay.chhablani{at}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.

  • Long-term outcome

https://doi.org/10.1136/bjophthalmol-2017-311805

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    Footnotes

    • Contributors CB, MR, CS, DZ, MI, LHL, AI, FV, KA, SS, AC, AM, RJ, HJ, AKA, NG, MN, VG, AB, AL, AOS, AMM and JC were involved in the conception and design of the study as well as in the data collection. CB, MR and JC were involved in the analysis and the interpretation of the data. CB, MR, DZ, MI, MO and JC were involved in literature research and writing the first drafts of the manuscript. All authors were involved in the critical revision and final approval of the article.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent Not required.

    • Provenance and peer review Not commissioned; externally peer reviewed.

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