title: Intravitreal dexamethasone implant for recalcitrant cystoid macular edema secondary to retinitis pigmentosa: a pilot study.
abstract: BACKGROUND
  To determine the utility of the intravitreal dexamethasone implant as therapy for cystoid macular edema (CME) secondary to retinitis pigmentosa (RP) recalcitrant to carbonic anhydrase inhibitor therapy over 2 years as a pilot study.
  
  
  METHODS
  This was a prospective case series. Patients who showed either an incomplete or no response to topical dorzolamide for at least 1 month and oral acetazolamide therapy for at least 15 days were recruited for the study with informed consent. A complete anterior and posterior segment examination was performed including fundus fluorescein angiography (FFA), optical coherence tomography scan (OCT) and electroretinogram to confirm the diagnosis. The dexamethasone implant was injected using a standardized technique. Follow ups were scheduled on days 1, 7, and 30 and then monthly thereafter for 2 years. The primary outcome measure was the change in corrected distance visual acuity (CDVA) and central subfield thickness (CST) at months 1, 6, 12, 18, and 24. The secondary outcome measure was complications, if any. Appropriate statistical analysis was done.
  
  
  RESULTS
  Five patients (two males; six eyes; median age 49 years) were recruited for the study. All patients required at least two injections over 2 years. All patients demonstrated significant improvement in CDVA (p = 0.004) as well as CST measurements (p = 0.0038) over 2 years. No complications were noted.
  
  
  CONCLUSIONS
  The intravitreal dexamethasone implant provides significant improvement in CDVA and CST measurements in patients with recalcitrant CME secondary to RP.
authors.affiliation: Eye Hospital and Retina Centre, Mahajan Lane, Raopura, Baroda, 390002, India. adityasudhalkar@yahoo.com.
authors.forename: Aditya
authors.initials: A
authors.lastname: Sudhalkar
authors.affiliation: Department of Ophthalmology, Croix-Rousse Teaching Hospital, Hospices Civils de Lyon, UMR-CNRS 5510 Matéis, University of Medicine Lyon 1, Lyon, France.
authors.forename: Laurent
authors.initials: L
authors.lastname: Kodjikian
authors.affiliation: Eye Hospital and Retina Centre, Mahajan Lane, Raopura, Baroda, 390002, India.
authors.forename: Nishikant
authors.initials: N
authors.lastname: Borse
mesh_terms: D000328:Adult; D003907:Dexamethasone / Q000008:administration & dosage*; D004305:Dose-Response Relationship, Drug; D004343:Drug Implants; D004596:Electroretinography; D005260:Female; D005451:Fluorescein Angiography; D005500:Follow-Up Studies; D005938:Glucocorticoids / Q000008:administration & dosage; D006801:Humans; D058449:Intravitreal Injections; D008269:Macular Edema / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011446:Prospective Studies; D012160:Retina / Q000473:pathology; D012174:Retinitis Pigmentosa / Q000150:complications* / Q000175:diagnosis; D041623:Tomography, Optical Coherence; D016896:Treatment Outcome; D014792:Visual Acuity
chemical_list: D004343:Drug Implants; D005938:Glucocorticoids; D003907:Dexamethasone
keywords: Central macular thickness; Corticosteroids; Dexamethasone implant; Macular edema; Ozurdex®; Retinitis pigmentosa