OBSERVED COMPLICATIONS FROM DEXAMETHASONE INTRAVITREAL IMPLANT FOR THE TREATMENT OF MACULAR EDEMA IN RETINAL VEIN OCCLUSION OVER 3 TREATMENT ROUNDS.
OBJECTIVE
To report adverse events after treatment of macular edema secondary to retinal vein occlusion with intravitreal dexamethasone implant (IDI) in a UK center across three treatment rounds.


METHODS
A review of 61 eyes receiving IDI treatment (1 implant [n = 61], 2 implants [n = 17], 3 implants [n = 6]). Data were collected at initiation and 2 and 6 months. Outcomes were intraocular pressure (IOP) (mean IOP, IOP >25 mmHg and IOP rise >10 mmHg) and cataract surgery. Other adverse events were recorded as they occurred. An adverse event incidence in central retinal vein occlusion versus branch retinal vein occlusion and glaucoma/ocular hypertension versus nonglaucoma/ocular hypertension subgroups was analyzed.


RESULTS
Ten eyes (12%) had IOP >25 mmHg, whereas 11% required medical and 1.2% required surgical IOP management. No significant IOP change was observed during the second/third implant rounds. The IOP was higher in the glaucoma/ocular hypertension and central retinal vein occlusion subgroups. Twenty-four percent of treated phakic eyes required cataract surgery, and the incidence increased with repeated implants. The mean time to cataract surgery from IDI initiation was 377 days.


CONCLUSIONS
Intraocular pressure rise is greatest 2 months after implant. In the absence of IOP complications after initial IDI exposure, repeated treatments do not represent an increased IOP risk profile. Central retinal vein occlusion and glaucoma/ocular hypertension subgroups are more likely to experience IOP-related side effects. The incidence of cataract surgery significantly increases with repeated IDI treatments.
Calderdale Royal Hospital, Halifax, West Yorkshire, United Kingdom.
Gerard A
GA
Reid
Dilraj S
DS
Sahota
Mahmoud
M
Sarhan
D000959:Antihypertensive Agents / Q000627:therapeutic use; D002386:Cataract / Q000139:chemically induced* / Q000628:therapy; D002387:Cataract Extraction / Q000706:statistics & numerical data; D003907:Dexamethasone / Q000008:administration & dosage / Q000009:adverse effects*; D004343:Drug Implants; D005901:Glaucoma / Q000139:chemically induced* / Q000188:drug therapy; D005938:Glucocorticoids / Q000008:administration & dosage / Q000009:adverse effects*; D006801:Humans; D007429:Intraocular Pressure / Q000187:drug effects*; D058449:Intravitreal Injections; D008269:Macular Edema / Q000188:drug therapy*; D009798:Ocular Hypertension / Q000139:chemically induced / Q000188:drug therapy; D012170:Retinal Vein Occlusion / Q000188:drug therapy*; D019233:Retreatment; D012189:Retrospective Studies; D041623:Tomography, Optical Coherence; D014065:Tonometry, Ocular; D014792:Visual Acuity / Q000187:drug effects
D000959:Antihypertensive Agents; D004343:Drug Implants; D005938:Glucocorticoids; D003907:Dexamethasone