title: Efficacy and safety of dexamethasone intravitreal implant for refractory macular edema in children.
abstract: OBJECTIVE
  To evaluate the efficacy and safety of dexamethasone (DEX) intravitreal implant (Ozurdex) in pediatric patients with cystoid macular edema (CME) refractory to conventional treatment.
  
  
  METHODS
  This study is a retrospective chart review.
  
  
  METHODS
  Four pediatric patients (5 eyes) with CME caused by uveitis, type I idiopathic macular telangiectasia (IMT), or Coats disease treated with DEX intravitreal implant.
  
  
  METHODS
  Medical records of the 4 pediatric patients (5 eyes) with CME included in this study were reviewed. Data collected included details of the underlying diseases, treatments, and pretreatment and post-treatment central retinal thickness (CRT) measured by time-domain optical coherence tomography, visual acuity (VA), intraocular pressure (IOP), and lens status. The median follow-up time was 65 weeks (range, 59-93 weeks).
  
  
  RESULTS
  Fifteen DEX intravitreal implants were injected into 5 eyes over the follow-up period. Reduction of CME was achieved in all eyes within 12 weeks after the initial injection. VA improved in 4 eyes and was unchanged in 1 eye at 12 weeks; VA improved in 2 eyes, decreased in 2 eyes, and was unchanged in 1 eye at 52 weeks. Three of 5 eyes experienced IOP elevation ≥ 10 mm Hg during the follow-up period. IOP was ultimately controlled medically in all eyes. Significant lens opacification was documented in 2 eyes.
  
  
  CONCLUSIONS
  DEX intravitreal implant can be considered as an effective adjunctive off-label treatment to pediatric macular edema caused by uveitis or IMT/Coats disease; the safety profile of repeated treatment is acceptable.
authors.affiliation: Program in Neurosciences and Mental Health.
authors.forename: Shaobo
authors.initials: S
authors.lastname: Lei
authors.affiliation: Department of Ophthalmology and Vision Sciences, The Hospital for Sick Children; Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ont.. Electronic address: waiching.lam@utoronto.ca.
authors.forename: Wai-Ching
authors.initials: WC
authors.lastname: Lam
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003907:Dexamethasone / Q000008:administration & dosage* / Q000009:adverse effects; D004343:Drug Implants; D005260:Female; D005500:Follow-Up Studies; D005938:Glucocorticoids / Q000008:administration & dosage* / Q000009:adverse effects; D006801:Humans; D007429:Intraocular Pressure; D008269:Macular Edema / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology; D008297:Male; D056687:Off-Label Use; D012008:Recurrence; D058456:Retinal Telangiectasis / Q000150:complications; D012189:Retrospective Studies; D041623:Tomography, Optical Coherence; D016896:Treatment Outcome; D014605:Uveitis / Q000150:complications; D014792:Visual Acuity / Q000502:physiology; D014822:Vitreous Body / Q000187:drug effects*
chemical_list: D004343:Drug Implants; D005938:Glucocorticoids; D003907:Dexamethasone