Intraocular Pressure in Patients with Retinal Vein Occlusions Treated With Repeated Dexamethasone Intravitreal Implant: A Retrospective Analysis

Abstract

Introduction: To assess the long-term findings of repeated Dexamethasone (DEX) implants in patients with Retinal Vein Occlusion (RVO) with the Intraocular Pressure (IOP) measures set as the primary end point. The second end point is the anatomical and functional findings. Methods: In this retrospective study, IOP, antiglaucoma treatment, Visual Acuity (VA), Central Macular Thickness (CMT), number of treatments, interval between treatments, and other safety outcomes data were collected at the Ophthalmology Department, Hopital Cantonal de Fribourg during 3 years. Results: Twenty-seven patients (28 eyes; 16 branch-RVO and 12 central-RVO) were eligible for analysis. Mean interval between diagnosis and treatment for treatment-naive and prior-treated patients (anti-VEGF) was 23 days and 18 months, respectively. Across six repeated treatments, IOP (i.e. ≥ 21 mmHg) was elevated in 23/27 patients, 13 received IOP-lowering medications. After the first DEX implant, mean VA improved from baseline (0.8 LogMAR (20/125 Snellen Equivalent)) at month 1 (0.6 LogMAR (20/80 approximate Snellen Equivalent)) followed by a gradual decline back to baseline at month 4. Following the first implant, mean CMT decreased from baseline (604.3 μm) to 381 μm and 426.1 μm at months 1 and 4, respectively, and remained similar until end of follow-up. A similar pattern of CMT reduction occurred following implants 2 and 3. Patients received a median of two implants, with a treatment interval of approximately 5 months. Conclusion: In a real-life clinical setting, intravitreal DEX improved VA and reduced CMT with no new safety concerns in patients with RVO. IOP elevation was transient and managed with short-term treatment with no cumulative effect on IOP elevation despite intervals <6 months , and no cases of glaucoma surgery recorded.