title: Rebound effect after intravitreal dexamethasone implant for the treatment of macular edema secondary to central retinal vein occlusion.
abstract: OBJECTIVE
  To report on the rebound macular edema (ME) effect following dexamethasone implant for the treatment of nonischemic central retinal vein occlusion (CRVO).
  
  
  METHODS
  Twenty-one patients affected by ME secondary to central retinal vein occlusion (CRVO) underwent an implant of dexamethasone (700 μg) in a compassionate use program. The patients were followed up monthly. The Early Treatment Diabetic Retinopathy Study (ETDRS) best corrected visual acuity (BCVA), central retinal thickness (CRT) on optical coherence tomography (OCT), and intraocular pressure were registered at monthly intervals. Retreatments were carried out on a pro-re-nata (PRN) basis starting from the third month.
  
  
  RESULTS
  Both BCVA and CRT improved in all cases. A rebound effect, characterized by a recurrence of ME in excess of the baseline value, occurred in 3 cases (13%) at months 3 and 4. Visual acuity accordingly dropped at the higher CRT values in the 3 cases displaying the rebound effect. Additional treatment with dexamethasone implant led to both a recovery in visual acuity and reduction in CRT.
  
  
  CONCLUSIONS
  A rebound effect can occur after dexamethasone implant for the treatment of ME related to CRVO, but does not affect functional or anatomical recovery when retreatment is provided. The retreatment rate with dexamethasone implant should be adapted to suit the patient's response.
authors: Department of Ophthalmology, University Vita-Salute, Scientific Institute San Raffaele, Milano, Italy.
authors: Maurizio Battaglia
authors: MB
authors: Parodi
authors: Pierluigi
authors: P
authors: Iacono
authors: Umberto
authors: U
authors: De Benedetto
authors: Marialucia
authors: M
authors: Cascavilla
authors: Francesco
authors: F
authors: Bandello
mesh_terms: D000368:Aged; D057176:Compassionate Use Trials; D003907:Dexamethasone / Q000008:administration & dosage / Q000627:therapeutic use*; D004343:Drug Implants; D005260:Female; D005500:Follow-Up Studies; D005938:Glucocorticoids / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D007429:Intraocular Pressure / Q000187:drug effects; D058449:Intravitreal Injections; D008269:Macular Edema / Q000188:drug therapy* / Q000209:etiology / Q000473:pathology; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012170:Retinal Vein Occlusion / Q000150:complications*; D019233:Retreatment; D013997:Time Factors; D041623:Tomography, Optical Coherence; D016896:Treatment Outcome; D014792:Visual Acuity / Q000187:drug effects
chemical_list: D004343:Drug Implants; D005938:Glucocorticoids; D003907:Dexamethasone