Initial Ten Years of Experience with the Intravitreal Dexamethasone Implant: A Retrospective Chart Review

Josh Wallsh,1 Charlotte Luths,2 Haily Kil,2 Ron Gallemore2 1Albany Medical Center, Department of Ophthalmology, Albany, NY, USA; 2Retina Macula Institute and Research Center, Torrance, CA, USACorrespondence: Ron GallemoreRetina Macula Institute and Research Center, 4201 Torrance Blvd Suite 220, Torr...

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Autores principales:	Wallsh J, Luths C, Kil H, Gallemore R
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2020
Materias:	uveitis branch retinal vein occlusion central retinal vein occlusion diabetic macular edema dexamethasone implant Ophthalmology RE1-994
Acceso en línea:	https://doaj.org/article/ac45a16b8e0d45e8b1001795fc25cce5
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spelling	oai:doaj.org-article:ac45a16b8e0d45e8b1001795fc25cce52021-12-02T13:00:15ZInitial Ten Years of Experience with the Intravitreal Dexamethasone Implant: A Retrospective Chart Review1177-5483https://doaj.org/article/ac45a16b8e0d45e8b1001795fc25cce52020-10-01T00:00:00Zhttps://www.dovepress.com/initial-ten-years-of-experience-with-the-intravitreal-dexamethasone-im-peer-reviewed-article-OPTHhttps://doaj.org/toc/1177-5483Josh Wallsh,1 Charlotte Luths,2 Haily Kil,2 Ron Gallemore2 1Albany Medical Center, Department of Ophthalmology, Albany, NY, USA; 2Retina Macula Institute and Research Center, Torrance, CA, USACorrespondence: Ron GallemoreRetina Macula Institute and Research Center, 4201 Torrance Blvd Suite 220, Torrance, CA 90503, USAEmail rongallemoremd@gmail.comPurpose: To evaluate the initial ten years of results from the intravitreal dexamethasone implant (DEX) in patients treated for retinal vein occlusion (RVO), diabetic macular edema (DME) or uveitis.Methods: Retrospective chart review of patients receiving DEX since its FDA approval. Best-corrected visual acuity (BCVA), central macular thickness (CMT) on optical coherence tomography, intraocular pressure and cataract status were collected. Baseline data were collected from the initial DEX and post-treatment data at the visit at least four weeks after the last DEX.Results: In total, 315 eyes received 1216 DEX over 63.9± 4.6 weeks. In the branch RVO (n=90), central RVO (n=59) and DME (n=62) cohorts, BCVA improved significantly (p< 0.05). The uveitis (n=154) cohort did not have a significant change in BCVA, 0.62± 0.04 to 0.61± 0.04 logMAR (p=0.34). Younger patients, vitrectomized eyes, and eyes without a history of glaucoma were associated with significantly better BCVA outcomes in the uveitis cohort (p< 0.05). Overall, CMT decreased significantly from 376.6± 6.8 to 322.7± 5.0 μm (p< 0.05). Intraocular pressure increased significantly (p< 0.001) and the percentage of patients requiring anti-glaucoma medications increased from 33.0% to 67.6%. Of phakic eyes, 58.8% (n=63) had cataract progression or underwent surgery with those who underwent surgery experiencing a significant improvement in BCVA (p< 0.05).Conclusion: Repeated DEX over extended follow-up offers significant anatomic benefits to all cohorts. Visual benefits are only seen in RVO, DME and select uveitis demographics.Keywords: uveitis, branch retinal vein occlusion, central retinal vein occlusion, diabetic macular edema, dexamethasone implantWallsh JLuths CKil HGallemore RDove Medical Pressarticleuveitisbranch retinal vein occlusioncentral retinal vein occlusiondiabetic macular edemadexamethasone implantOphthalmologyRE1-994ENClinical Ophthalmology, Vol Volume 14, Pp 3097-3108 (2020)
institution	DOAJ
collection	DOAJ
language	EN
topic	uveitis branch retinal vein occlusion central retinal vein occlusion diabetic macular edema dexamethasone implant Ophthalmology RE1-994
spellingShingle	uveitis branch retinal vein occlusion central retinal vein occlusion diabetic macular edema dexamethasone implant Ophthalmology RE1-994 Wallsh J Luths C Kil H Gallemore R Initial Ten Years of Experience with the Intravitreal Dexamethasone Implant: A Retrospective Chart Review
description	Josh Wallsh,1 Charlotte Luths,2 Haily Kil,2 Ron Gallemore2 1Albany Medical Center, Department of Ophthalmology, Albany, NY, USA; 2Retina Macula Institute and Research Center, Torrance, CA, USACorrespondence: Ron GallemoreRetina Macula Institute and Research Center, 4201 Torrance Blvd Suite 220, Torrance, CA 90503, USAEmail rongallemoremd@gmail.comPurpose: To evaluate the initial ten years of results from the intravitreal dexamethasone implant (DEX) in patients treated for retinal vein occlusion (RVO), diabetic macular edema (DME) or uveitis.Methods: Retrospective chart review of patients receiving DEX since its FDA approval. Best-corrected visual acuity (BCVA), central macular thickness (CMT) on optical coherence tomography, intraocular pressure and cataract status were collected. Baseline data were collected from the initial DEX and post-treatment data at the visit at least four weeks after the last DEX.Results: In total, 315 eyes received 1216 DEX over 63.9± 4.6 weeks. In the branch RVO (n=90), central RVO (n=59) and DME (n=62) cohorts, BCVA improved significantly (p< 0.05). The uveitis (n=154) cohort did not have a significant change in BCVA, 0.62± 0.04 to 0.61± 0.04 logMAR (p=0.34). Younger patients, vitrectomized eyes, and eyes without a history of glaucoma were associated with significantly better BCVA outcomes in the uveitis cohort (p< 0.05). Overall, CMT decreased significantly from 376.6± 6.8 to 322.7± 5.0 μm (p< 0.05). Intraocular pressure increased significantly (p< 0.001) and the percentage of patients requiring anti-glaucoma medications increased from 33.0% to 67.6%. Of phakic eyes, 58.8% (n=63) had cataract progression or underwent surgery with those who underwent surgery experiencing a significant improvement in BCVA (p< 0.05).Conclusion: Repeated DEX over extended follow-up offers significant anatomic benefits to all cohorts. Visual benefits are only seen in RVO, DME and select uveitis demographics.Keywords: uveitis, branch retinal vein occlusion, central retinal vein occlusion, diabetic macular edema, dexamethasone implant
format	article
author	Wallsh J Luths C Kil H Gallemore R
author_facet	Wallsh J Luths C Kil H Gallemore R
author_sort	Wallsh J
title	Initial Ten Years of Experience with the Intravitreal Dexamethasone Implant: A Retrospective Chart Review
title_short	Initial Ten Years of Experience with the Intravitreal Dexamethasone Implant: A Retrospective Chart Review
title_full	Initial Ten Years of Experience with the Intravitreal Dexamethasone Implant: A Retrospective Chart Review
title_fullStr	Initial Ten Years of Experience with the Intravitreal Dexamethasone Implant: A Retrospective Chart Review
title_full_unstemmed	Initial Ten Years of Experience with the Intravitreal Dexamethasone Implant: A Retrospective Chart Review
title_sort	initial ten years of experience with the intravitreal dexamethasone implant: a retrospective chart review
publisher	Dove Medical Press
publishDate	2020
url	https://doaj.org/article/ac45a16b8e0d45e8b1001795fc25cce5
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Initial Ten Years of Experience with the Intravitreal Dexamethasone Implant: A Retrospective Chart Review

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