title: Retinal vein occlusion and the use of a dexamethasone intravitreal implant (Ozurdex®) in its treatment.
abstract: OBJECTIVE
  To review published data pertaining to the clinical experience with a dexamethasone intravitreal implant (Ozurdex®) with a view to establishing a clinically based therapeutic regime.
  
  
  METHODS
  A PubMed search using the MeSH terms "retinal vein occlusion" and either "pathophysiology" or "dexamethasone intravitreal implant" was undertaken for manuscripts published until August 2015. The analysis included studies involving minimally 15 patients under a prospective design or 30 under a retrospective design, a minimal follow up of 6 months, and at least 2 intravitreal Ozurdex® injections per eye.
  
  
  RESULTS
  In the vast majority of eyes, satisfactory outcomes were achieved with retreatment intervals of between 3 and 5 months. Initial evidence indicates a similar efficacy compared to anti-VEGF therapies as a first-line treatment. Safety concerns associated with the long-term and repeated use of Ozurdex® are not borne out by clinical findings: its implantation is not associated with a sustained increase in intraocular pressure (IOP) over time or with the number of applications.
  
  
  CONCLUSIONS
  Compared with anti-VEGF therapies, the burden of retreatment is reduced. In patients with chronic macular edema not responsive to repetitive anti-VEGF therapies, the outcome after dexamethasone implant treatment is encouraging. However, these results are achieved at the expense of side effects typically associated with steroids: in up to 20 % of the Ozurdex®-treated patients, an elevation in IOP, which could be medically controlled in the majority of cases, and cataract formation or progression was observed.
authors.affiliation: Berner Augenklinik am Lindenhofspital, University of Bern, Swiss Eye Institute, Luzerner Strasse 1, CH-6343, Rotkreuz, Bern, Switzerland. justus.garweg@augenklinik-bern.ch.
authors.forename: Justus G
authors.initials: JG
authors.lastname: Garweg
authors.affiliation: Berner Augenklinik am Lindenhofspital, University of Bern, Swiss Eye Institute, Luzerner Strasse 1, CH-6343, Rotkreuz, Bern, Switzerland.
authors.forename: Souska
authors.initials: S
authors.lastname: Zandi
mesh_terms: D003907:Dexamethasone / Q000008:administration & dosage*; D004343:Drug Implants; D005938:Glucocorticoids / Q000008:administration & dosage; D006801:Humans; D058449:Intravitreal Injections; D012170:Retinal Vein Occlusion / Q000175:diagnosis / Q000188:drug therapy*; D041623:Tomography, Optical Coherence; D016896:Treatment Outcome; D014792:Visual Acuity
chemical_list: D004343:Drug Implants; D005938:Glucocorticoids; D003907:Dexamethasone
keywords: Branch retinal vein occlusion; Central retinal vein occlusion; Copernicus; Dexamethasone; Galileo; Geneva; Intravitreal implant; Mead; Pathophysiology; Retinal vein occlusion; Review of literature; Score; Shasta