J Korean Ophthalmol Soc.  2019 Sep;60(9):843-850. 10.3341/jkos.2019.60.9.843.

The Effect of Epiretinal Membrane on Dexamethasone Implant for Branch Retinal Vein Occlusion Macular Edema

• Jang M
• Kim JY
• Lee SY
• Jeong JH
• Lee EK

• KMID: 2459128
• DOI: http://doi.org/10.3341/jkos.2019.60.9.843

Abstract

PURPOSE
To evaluate the effect of epiretinal membrane (ERM) on the outcomes of intravitreal dexamethasone implant (Ozurdex®, Allergan, Irvine, CA, USA) treatment for macular edema (ME) secondary to branch retinal vein occlusion (BRVO).
METHODS
Thirty eyes of 30 patients who received Ozurdex treatment for ME secondary to BRVO, and were followed-up for at least 6 months were retrospectively reviewed. Patients were divided into two groups based on the presence (ERM [+] or absence ERM [−]) of ERM at baseline. The best-corrected visual acuity (BCVA), central foveal thickness (CFT), recurrence of ME, and retreatment rate were evaluated at baseline, 1, 3, and 6 months after Ozurdex injection.
RESULTS
Ten eyes of 30 eyes (33%) showed ERM at baseline. While the mean CFT was significantly reduced at 1 month after Ozurdex injection, it began to increase gradually thereafter in both groups. The ERM (+) group showed a significantly higher mean CFT than the corresponding values of the ERM (−) group at 1 (p = 0.022) and 6 months (p = 0.001) after Ozurdex injection. However, no significant difference was found in the BCVA between the two groups at every visit. The proportion of eyes with ME was significantly higher in the ERM (+) group (90%) than that in the ERM (−) group (35%) at 6 months after Ozurdex injection (p = 0.009). There were no significant differences between the two groups in the percentage of retreatment, time to retreatment, and type of materials used for retreatment.
CONCLUSIONS
In patients with ME secondary to BRVO, the treatment effect of Ozurdex was low and the duration of treatment was short when ERM was concurrently present. However, the presence of ERM did not significantly affect visual outcomes after treatment with Ozurdex.

Keyword

Branch retinal vein occlusion; Epiretinal membrane; Intravitreal dexamethasone implant; Macular edema

MeSH Terms

Dexamethasone*
Edema*
Epiretinal Membrane*
Humans
Macular Edema
Recurrence
Retinal Vein Occlusion*
Retinal Vein*
Retinaldehyde*
Retreatment
Retrospective Studies
Visual Acuity
Dexamethasone
Retinaldehyde

Figure

• 

  Figure 1 Representative optical coherence tomography images in patients with branch retinal vein occlusion associated with macular edema and treated with intravitreal dexamethasone implant (Ozurdex®, Allergan, Irvine, CA, USA). (A) The eye without epiretinal membrane (ERM) showed severe macular edema at baseline. After Ozurdex injection, no significant recurrence was observed during the 6-month of follow-up period. (B) The eye with ERM also showed significant macular edema at baseline. The macular edema absorbed at 1 month after Ozurdex injection but recurred at 3 months. At 3 months, an additional injection of bevacizumab was performed, but the macular edema persisted at 6 months.

• 

  Figure 2 Chronological changes in mean central foveal thickness (CFT) (A) and best-corrected visual acuity (BCVA) (B) in ERM (−) and ERM (+) groups. (A) The ERM (+) group showed significantly higher mean CFT at 1 and 6 months after Ozurdex injection than the corresponding values of ERM (−) group. (B) There were no significant differences in BCVA between the two groups at every visit. *p<0.05, **p<0.01 for comparisons between groups at each follow-up visit.

• 

  Figure 3 The proportion of eyes with macular edema in ERM (−) and ERM (+) groups. It was significantly higher in ERM (+) group than that of ERM (−) group at 6 months after Ozurdex injection. ME = macular edema. *p < 0.01 for comparisons between groups at each follow-up visit.

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