Response of postoperative and chronic uveitic cystoid macular edema to a dexamethasone-based intravitreal implant (Ozurdex)

Abstract

PURPOSE: To survey the clinical responses to treatment of chronic postoperative and uveitic cystoid macular edema (CME) with a dexamethasone-based intravitreal implant (Ozurdex(®)). METHODS: This retrospective, interventional case series reports on patients with chronic CME after uncomplicated vitrectomy for epiretinal gliosis or phacoemulsification (group 1: 12 eyes) or secondary to noninfectious endogenous uveitis (group 2: 36 eyes). Central retinal thickness (CRT), best-corrected visual acuity (BCVA, logMAR), and intraocular pressure (IOP) throughout follow-up were gleaned from the medical records. RESULTS: In group 1, CRT decreased, compared with baseline, from 519 $±$ 43 to 297 $±$ 23 and 356 $±$ 49 $μ$m by the 1- and 3-month visit (P = 0.02) and to 429 $±$ 57 $μ$m before reimplantation. In group 2, CRT decreased from 460 $±$ 31 to 300 $±$ 21 and 312 $±$ 26 $μ$m by the 1- and 3-month follow-up, respectively (P = 0.001), and to 373 $±$ 32 $μ$m before reimplantation. Complete resolution of CME was achieved in 67% and 94% (groups 1 and 2, respectively) by 1 month and in 42% and 80% by 3 months after injection. In group 1, BCVA improved from 0.46 $±$ 0.08 to 0.27 $±$ 0.09 and 0.20 $±$ 0.06 (P = 0.01) by the 1- and 3-month follow-up, respectively, and to 0.32 $±$ 0.08 before reimplantation. In group 2, BCVA improved from 0.47 $±$ 0.06 to 0.34 $±$ 0.09, 0.26 $±$ 0.07, and 0.29 $±$ 0.08 (P < 0.05) at 1 and 3 months of follow-up and before reimplantation, respectively. A significant IOP increase was not observed in either group. Mean time to reimplantation of Ozurdex was 6.4 $±$ 5.7 and 6.6 $±$ 3.4 months for postoperative and uveitic CME, respectively. CONCLUSION: Ozurdex seems to achieve a sustained effect over up to 6 months in postsurgical and uveitic CME.

Publication
J. Ocul. Pharmacol. Ther.