title: Repeated intravitreal dexamethasone implant (Ozurdex®) for retinal vein occlusion.
abstract: OBJECTIVE
  To evaluate the effects of repeated intravitreal dexamethasone implant (IDI) (Ozurdex®) in eyes with macular edema (ME) due to retinal vein occlusion (RVO).
  
  
  METHODS
  We reviewed the charts of patients with RVO-related ME, who received repeated Ozurdex IDI (0.7 mg) on an 'as-needed' basis. Main outcome measures included changes in best-corrected visual acuity (BCVA), central macular thickness (CMT), retreatment interval, and incidence of side effects.
  
  
  RESULTS
  A total of 33 eyes were included for analysis. Retreatment with Ozurdex was judged necessary after 4.7 ± 1.1 months from the first IDI (1st IDI) and 5.1 ± 1.5 months from the second IDI (2nd IDI). Baseline BCVA was 0.65 ± 0.43 logMAR; it significantly improved to 0.50 ± 0.42 logMAR after 1.4 ± 0.7 months from the 1st IDI (peaking efficacy) (p < 0.001) and to 0.48 ± 0.44 logMAR after 1.8 ± 0.8 months from the 2nd IDI (peaking efficacy) (p < 0.001). CMT decreased from 636 ± 217 µm (baseline) to 300 ± 114 µm, 1.4 ± 0.7 months after the 1st IDI (p < 0.001), and to 298 ± 91 µm, 1.8 ± 0.8 months after the 2nd IDI (p < 0.001). A rebound effect was recorded in 7 eyes after the 1st IDI (mean 168 ± 158 µm) and in 4 eyes after the 2nd IDI (mean 215 ± 199 µm). All eyes with a rebound effect improved again after a 2nd intravitreal Ozurdex injection. No serious adverse events were observed; 12 eyes developed a transient IOP increase, and cataracts were extracted in 2 eyes.
  
  
  CONCLUSIONS
  Repeated intravitreal Ozurdex on an 'as-needed' basis, with a retreatment interval <6 months, may produce long-term clinically meaningful benefits in the treatment of ME due to RVO, without other significant side effects than expected after intraocular corticosteroid treatment.
authors.affiliation: Department of Ophthalmology, University Scientific Institute San Raffaele, Milan, Italy.
authors.forename: Lea
authors.initials: L
authors.lastname: Querques
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Querques
authors.forename: Rosangela
authors.initials: R
authors.lastname: Lattanzio
authors.forename: Silvia Rita
authors.initials: SR
authors.lastname: Gigante
authors.forename: Claudia
authors.initials: C
authors.lastname: Del Turco
authors.forename: Giulia
authors.initials: G
authors.lastname: Corradetti
authors.forename: Maria Lucia
authors.initials: ML
authors.lastname: Cascavilla
authors.forename: Francesco
authors.initials: F
authors.lastname: Bandello
mesh_terms: D003907:Dexamethasone / Q000008:administration & dosage*; D004343:Drug Implants; D005260:Female; D005500:Follow-Up Studies; D005938:Glucocorticoids / Q000008:administration & dosage; D006801:Humans; D058449:Intravitreal Injections; D008297:Male; D008875:Middle Aged; D012170:Retinal Vein Occlusion / Q000175:diagnosis / Q000188:drug therapy*; D019233:Retreatment; D041623:Tomography, Optical Coherence; D014792:Visual Acuity
chemical_list: D004343:Drug Implants; D005938:Glucocorticoids; D003907:Dexamethasone