title: Effectiveness and safety of dexamethasone implants for post-surgical macular oedema including Irvine-Gass syndrome: the EPISODIC study.
abstract: OBJECTIVE
  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.
authors.affiliation: Department of Ophthalmology, Croix-Rousse University Hospital, Hospices Civils de Lyon, University of Lyon I, Lyon, France CNRS UMR 5510 Mateis, Villeurbanne, France.
authors.forename: David
authors.initials: D
authors.lastname: Bellocq
authors.affiliation: Université de Bordeaux, ISPED, Centre INSERM U897-Epidemiologie-Biostatistique, Bordeaux, France INSERM, ISPED, CHUde Bordeaux, France Service d'ophtalmologie, CHUde Bordeaux, France.
authors.forename: Jean-François
authors.initials: JF
authors.lastname: Korobelnik
authors.affiliation: Department of Ophthalmology, Edouard Herriot Hospital, University of Lyon I, Lyon, France Institut de Biologie et Chimie des Protéines, CNRS/UMR5086, Lyon, France.
authors.forename: Carole
authors.initials: C
authors.lastname: Burillon
authors.affiliation: 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.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Voirin
authors.affiliation: Department of Ophthalmology, Desgenettes military Hospital, University of Val de Grâce, Lyon, France.
authors.forename: Corinne
authors.initials: C
authors.lastname: Dot
authors.affiliation: Hopital Intercommunal de Creteil, University Paris Est, Creteil, France.
authors.forename: Eric
authors.initials: E
authors.lastname: Souied
authors.affiliation: Centre d'Ophtalmologie Monticelli-Paradis, Marseille, France.
authors.forename: John
authors.initials: J
authors.lastname: Conrath
authors.affiliation: Department of Ophthalmology, University of Picardie Jules Verne, Clinic Saint Victor, 354, Boulevard of Beauville, Amiens, France Center n° 86 of network EVICR-net.
authors.forename: Solange
authors.initials: S
authors.lastname: Milazzo
authors.affiliation: Department of Ophthalmology, Assistance Publique-Hôpitaux de Paris (AP-HP) Université Paris 7, Hôpital Lariboisière, Paris, France.
authors.forename: Pascale
authors.initials: P
authors.lastname: Massin
authors.affiliation: Departement of Ophthalmology, Saint Roch University Hospital, Nice Sophia Antipolis, Nice, France.
authors.forename: Stéphanie
authors.initials: S
authors.lastname: Baillif
authors.affiliation: Department of Ophthalmology, Croix-Rousse University Hospital, Hospices Civils de Lyon, University of Lyon I, Lyon, France CNRS UMR 5510 Mateis, Villeurbanne, France.
authors.forename: Laurent
authors.initials: L
authors.lastname: Kodjikian
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003907:Dexamethasone / Q000008:administration & dosage* / Q000009:adverse effects; D004343:Drug Implants; D019773:Epiretinal Membrane / Q000601:surgery; D005260:Female; D005938:Glucocorticoids / Q000008:administration & dosage* / Q000009:adverse effects; D006801:Humans; D007429:Intraocular Pressure / Q000502:physiology; D058449:Intravitreal Injections; D008269:Macular Edema / Q000188:drug therapy* / Q000209:etiology / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D018918:Phacoemulsification; D011183:Postoperative Complications; D012160:Retina / Q000473:pathology; D012163:Retinal Detachment / Q000601:surgery; D012189:Retrospective Studies; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology; D014821:Vitrectomy; D014822:Vitreous Body
chemical_list: D004343:Drug Implants; D005938:Glucocorticoids; D003907:Dexamethasone
keywords: Drugs; Inflammation; Macula; Treatment Medical