title: Real-world assessment of intravitreal dexamethasone implant (0.7 mg) in patients with macular edema: the CHROME study.
abstract: BACKGROUND
  The purpose of this study was to evaluate the real-world use, efficacy, and safety of one or more dexamethasone intravitreal implant(s) 0.7 mg (DEX implant) in patients with macular edema (ME).
  
  
  METHODS
  This was a retrospective cohort study of patients with ME secondary to retinal disease treated at ten Canadian retina practices, including one uveitis center. Best-corrected visual acuity (BCVA), central retinal thickness (CRT), intraocular pressure (IOP), glaucoma and cataract surgery, and safety data were collected from the medical charts of patients with ≥3 months of follow-up after the initial DEX implant.
  
  
  RESULTS
  One hundred and one patient charts yielded data on 120 study eyes, including diagnoses of diabetic ME (DME) (n=34), retinal vein occlusion (RVO, n=30; branch in 19 and central in 11), and uveitis (n=23). Patients had a mean age of 60.9 years, and 73.3% of the study eyes had ME for a duration of ≥12 months prior to DEX implant injection(s). Baseline mean (± standard error) BCVA was 0.63±0.03 logMAR (20/86 Snellen equivalents) and mean CRT was 474.4±18.2 μm. The mean number of DEX implant injections was 1.7±0.1 in all study eyes; 44.2% of eyes had repeat DEX implant injections (reinjection interval 2.3-4.9 months). The greatest mean peak changes in BCVA lines of vision occurred in study eyes with uveitis (3.3±0.6, P<0.0001), followed by RVO (1.3±0.5, P<0.01) and DME (0.7±0.5, P>0.05). Significant decreases in CRT were observed: -255.6±43.6 μm for uveitis, -190.9±23.5 μm for DME, and -160.7±39.6 μm for RVO (P<0.0001 for all cohorts). IOP increases of ≥10 mmHg occurred in 20.6%, 24.1%, and 22.7% of DME, RVO, and uveitis study eyes, respectively. IOP-lowering medication was initiated in 29.4%, 16.7%, and 8.7% of DME, RVO, and uveitis study eyes, respectively. Glaucoma surgery was performed in 1.7% of all study eyes and cataract surgery in 29.8% of all phakic study eyes receiving DEX implant(s).
  
  
  CONCLUSIONS
  DEX implant(s) alone or combined with other treatments and/or procedures resulted in functional and anatomic improvements in long-standing ME associated with retinal disease.
authors.affiliation: Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, ON, Canada.
authors.forename: Wai-Ching
authors.initials: WC
authors.lastname: Lam
authors.affiliation: West Coast Retinal Consultants, Vancouver, BC, Canada.
authors.forename: David A
authors.initials: DA
authors.lastname: Albiani
authors.affiliation: North Toronto Eye Care, North York, ON, Canada.
authors.forename: Pradeepa
authors.initials: P
authors.lastname: Yoganathan
authors.affiliation: Department of Ophthalmology, McGill University, Montreal, QC, Canada.
authors.forename: John Chanchiang
authors.initials: JC
authors.lastname: Chen
authors.affiliation: Southern Alberta Eye Center, Calgary, AB, Canada.
authors.forename: Amin
authors.initials: A
authors.lastname: Kherani
authors.affiliation: Department of Ophthalmology and Visual Sciences, University of British Columbia, Vancouver, BC, Canada.
authors.forename: David Al
authors.initials: DA
authors.lastname: Maberley
authors.affiliation: Timmins and District Hospital, Timmins, ON, Canada.
authors.forename: Alejandro
authors.initials: A
authors.lastname: Oliver
authors.affiliation: North Toronto Eye Care, North York, ON, Canada.
authors.forename: Theodore
authors.initials: T
authors.lastname: Rabinovitch
authors.affiliation: Ivey Eye Institute, London, ON, Canada.
authors.forename: Thomas G
authors.initials: TG
authors.lastname: Sheidow
authors.affiliation: Center Oculaire de Quebec, Quebec City, QC, Canada.
authors.forename: Eric
authors.initials: E
authors.lastname: Tourville
authors.affiliation: Retina Surgical Associates, New Westminster, BC, Canada.
authors.forename: Leah A
authors.initials: LA
authors.lastname: Wittenberg
authors.affiliation: Clinwest Research Inc, Burlington, ON, Canada.
authors.forename: Chris
authors.initials: C
authors.lastname: Sigouin
authors.affiliation: Allergan Inc., Markham, ON, Canada.
authors.forename: Darryl C
authors.initials: DC
authors.lastname: Baptiste
keywords: Ozurdex®; diabetic macular edema; posterior segment inflammatory disease; registry; retinal vein occlusion; sustained-release dexamethasone implant