Safety and long-Term Outcomes of Repeated Dexamethasone Intravitreal Implant (OZURDEX®) for the Management of Macular Edema

Purpose: This study to assess the efficacy and the safety of repeated dexamethasone intravitreal implant (Ozurdex ® ) in vascular macular edema in real-life practice. Materials and Methods: This was a 22-month prospective study, including eyes with vascular macular edema according to the inclusion criteria. Baseline and follow-up visits included best-corrected visual acuity (BCVA) measurement, slit-lamp biomicroscopy, dilated fundoscopy, intraocular pressure (IOP) measurement, and central macular thickness (CMT) measurement with optical coherence tomography. Main outcomes included changes in BCVA and CMT at the 1 st , 2 nd , 4 th , and 6 th months; time to retreatment; and incidence of side effects. Results: A total of 31 eyes of 24 patients were included in the present study. After the first intravitreal injection, BCVA (baseline 0.940 ± 0.463 LogMAR) improved significantly to 0.483 ± 0.323 LogMAR at 2 nd month ( P = 0.000), 0.657 ± 0.357 at 4 th month ( P = 0.000), and 0.690 ± 0,448 at 6 th month ( P = 0.001). Mean CMT (baseline = 582.51 ± 148.20) decreased statistically significantly at 2 nd month and 4 th month after the first intravitreal injection (245.87 ± 103.86 and 456.68 ± 182.735, respectively, both P < 0.001 vs. baseline). At the 6 th month, CMT was 407.93 ± 212.70 for the 16 eyes that had not been reinjected versus baseline CMT 576.93 ± 158.56 ( P = 0.008). After other Ozurdex ® injections, we had the same visual acuity gain and CMT reduction, an average of 2.03 ± 0.83 injections were done. The most common side effects were cataract development and rise in IOP. Conclusion: Ozurdex ® implant is an effective treatment for vascular macular edema with a good safety profile; however, its effectiveness seems to decrease with time requiring repeated injections.