Long-term visual outcome and its predictors in macular oedema secondary to retinal vein occlusion treated with dexamethasone implant.


Journal

The British journal of ophthalmology
ISSN: 1468-2079
Titre abrégé: Br J Ophthalmol
Pays: England
ID NLM: 0421041

Informations de publication

Date de publication:
04 2019
Historique:
received: 26 12 2017
revised: 02 04 2018
accepted: 24 05 2018
pubmed: 13 6 2018
medline: 20 12 2019
entrez: 13 6 2018
Statut: ppublish

Résumé

To evaluate the functional long-term outcome in patients with macular oedema (MO) secondary to central retinal vein occlusion (CRVO) and branch retinal vein occlusion (BRVO) treated with dexamethasone implant (DEX implant) and to identify its clinical predictors. A 24-month, retrospective, multinational, real-world study. Chart review of patients with either naïve or recurrent MO secondary to CRVO/BRVO treated with DEX implant, including best-corrected visual acuity (BCVA), central subfield thickness (CST), demographic baseline characteristics and details of any additional treatment during follow-up. A total of 155 eyes (65 CRVO, 90 BRVO) from 155 patients were included. At 24 months, mean BCVA did not change significantly in CRVO (-2.1±24.5 letters, p=0.96) and BRVO patients (1.3±27.0 letters, p=0.07). A worse baseline BCVA (p<0.001), visual acuity (VA) gain ≥5 letters at 2 months (p=0.006) and no need for adjunctive intravitreal therapy after first DEX implant (p=0.001) were associated with a better final BCVA gain. Treatment-naïve patients (p=0.006, OR: 0.25, 95% CI 0.11 to 0.57) and those with a baseline CST≤400 µm (p=0.02, OR: 0.25, 95% CI 0.10 to 0.63) were identified as being less likely to need additional intravitreal therapy. Clinical baseline characteristics and the early treatment response were identified as possible predictors for long-term outcome and the need of adjunctive intravitreal therapy in MO secondary to BRVO/CRVO treated by DEX implant.

Sections du résumé

BACKGROUND
To evaluate the functional long-term outcome in patients with macular oedema (MO) secondary to central retinal vein occlusion (CRVO) and branch retinal vein occlusion (BRVO) treated with dexamethasone implant (DEX implant) and to identify its clinical predictors.
METHODS
A 24-month, retrospective, multinational, real-world study. Chart review of patients with either naïve or recurrent MO secondary to CRVO/BRVO treated with DEX implant, including best-corrected visual acuity (BCVA), central subfield thickness (CST), demographic baseline characteristics and details of any additional treatment during follow-up.
RESULTS
A total of 155 eyes (65 CRVO, 90 BRVO) from 155 patients were included. At 24 months, mean BCVA did not change significantly in CRVO (-2.1±24.5 letters, p=0.96) and BRVO patients (1.3±27.0 letters, p=0.07). A worse baseline BCVA (p<0.001), visual acuity (VA) gain ≥5 letters at 2 months (p=0.006) and no need for adjunctive intravitreal therapy after first DEX implant (p=0.001) were associated with a better final BCVA gain. Treatment-naïve patients (p=0.006, OR: 0.25, 95% CI 0.11 to 0.57) and those with a baseline CST≤400 µm (p=0.02, OR: 0.25, 95% CI 0.10 to 0.63) were identified as being less likely to need additional intravitreal therapy.
CONCLUSION
Clinical baseline characteristics and the early treatment response were identified as possible predictors for long-term outcome and the need of adjunctive intravitreal therapy in MO secondary to BRVO/CRVO treated by DEX implant.

Identifiants

pubmed: 29891733
pii: bjophthalmol-2017-311805
doi: 10.1136/bjophthalmol-2017-311805
doi:

Substances chimiques

Drug Implants 0
Glucocorticoids 0
Dexamethasone 7S5I7G3JQL

Types de publication

Journal Article Multicenter Study

Langues

eng

Sous-ensembles de citation

IM

Pagination

463-468

Informations de copyright

© Author(s) (or their employer(s)) 2019. No commercial re-use. See rights and permissions. Published by BMJ.

Déclaration de conflit d'intérêts

Competing interests: None declared.

Auteurs

Catharina Busch (C)

Department of Ophthalmology, University Hospital Leipzig, Leipzig, Germany.

Matus Rehak (M)

Department of Ophthalmology, University Hospital Leipzig, Leipzig, Germany.

Chintan Sarvariya (C)

Banker's Retina Clinic & Laser Center, Ahmedabad, India.

Dinah Zur (D)

Division of Ophthalmology, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.

Matias Iglicki (M)

Private Retina Office, University of Buenos Aires, Buenos Aires, Argentina.

Luiz H Lima (LH)

Department of Ophthalmology and Visual Sciences, Federal University of Sao Paulo, Sao Paulo, Brazil.

Alessandro Invernizzi (A)

Eye Clinic - Department of Biomedical and Clinical Science 'L. Sacco', Luigi Sacco Hospital, University of Milan, Milan, Italy.
Save Sight Institute , University of Sydney, Sydney, NSW, Australia.

Francesco Viola (F)

Department of Clinical Sciences and Community Health, University of Milan, Ophthalmological Unit, IRCCS-Cà Granda Foundation - Ospedale Maggiore Policlinico, Milan, Italy.

Kushal Agrawal (K)

L.V. Prasad Eye Institute, Banjara Hills, Hyderabad, India.

Suthasinee Sinawat (S)

Department of Ophthalmology, Faculty of Medicine, Srinagarind Hospital, Khon Kaen University, Khon Kaen, Thailand.

Aude Couturier (A)

Service d'Ophtalmologie, Hôspital Lariboisière, Université Paris, Sorbonne Paris Cité, Paris, France.

Aanchal Mehta (A)

ICARE Eye Hospital and Postgraduate Institute, Noida, India.

Rakesh Juneja (R)

Retina Foundation and Eye Research Center, Ahmedabad, India.

Hardik Jain (H)

Retina Foundation and Eye Research Center, Ahmedabad, India.

Aniruddha Kishandutt Agarwal (AK)

Post Graduate Institute of Medical Education and Research, Chandigarh, India.

Neha Goel (N)

ICARE Eye Hospital and Postgraduate Institute, Noida, India.

Manish Nagpal (M)

Retina Foundation and Eye Research Center, Ahmedabad, India.

Vishali Gupta (V)

Post Graduate Institute of Medical Education and Research, Chandigarh, India.

Alay Banker (A)

Banker's Retina Clinic & Laser Center, Ahmedabad, India.

Anat Loewenstein (A)

Division of Ophthalmology, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.

Mali Okada (M)

Royal Victorian Eye and Ear Hospital, Melbourne, Victoria, Australia.

Ali Osman Saatci (AO)

Dokuz Eylul University, İzmir, Turkey.

Ahmad M Mansour (AM)

Department of Ophthalmology, American University of Beirut, Beirut, Lebanon.
Department of Ophthalmology, Rafic Hariri University Hospital, Beirut, Lebanon.

Jay Chhablani (J)

L.V. Prasad Eye Institute, Banjara Hills, Hyderabad, India jay.chhablani@gmail.com.

Articles similaires

[Redispensing of expensive oral anticancer medicines: a practical application].

Lisanne N van Merendonk, Kübra Akgöl, Bastiaan Nuijen
1.00
Humans Antineoplastic Agents Administration, Oral Drug Costs Counterfeit Drugs

Smoking Cessation and Incident Cardiovascular Disease.

Jun Hwan Cho, Seung Yong Shin, Hoseob Kim et al.
1.00
Humans Male Smoking Cessation Cardiovascular Diseases Female
Humans United States Aged Cross-Sectional Studies Medicare Part C
1.00
Humans Yoga Low Back Pain Female Male

Classifications MeSH