Local safety of repeated intravitreal Ozurdex

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Sir,

The article entitled ‘Twelve-month experience with Ozurdex for the treatment of macular edema associated with retinal vein occlusion’1 highlights the significant cataract progression in eyes receiving more than one Ozurdex implant. We retrospectively reviewed the charts of all patients with macular edema secondary to retinal vein occlusion (RVO) refractory to current therapies and treated with Ozurdex from April 2010 until March 2012.

The mean age of patients with branch RVO (n=33) was 72.4. In eyes receiving a second Ozurdex implant, four out of the five phakic eyes showed progression of cataract requiring surgery. We registered one case of anterior chamber migration resulting in a bullous keratopathy.2 The mean age of patients with CRVO (n=23) was 68.3. In eye receiving a second Ozurdex implant, four out of the six phakic eyes showed progression of cataract requiring surgery.

Real-life studies are necessary in order to better define the safety and efficacy of new therapeutic approaches. Although the GENEVA study3 reported an incidence of 29.8% of cataract progression in eyes receiving a second Ozurdex intravitreal implant, Mayer et al1 found a significant higher proportion of these eyes in their study after a third implant (50.0%), and we also evidenced a higher progression of lens opacity in patients with macular edema secondary to RVO refractory to conventional therapies receiving a second implant (75.0% in branch RVO and 66.7% in central RVO). These data should be taken into account when an individualized strategy is planned for patients with RVO.

References

  1. 1

    Mayer WJ, Wolf A, Kernt M, Kook D, Kampik A, Ulbig M et al. Twelve-month experience with Ozurdex for the treatment of macular edema associated with retinal vein occlusion. Eye 2013; 27 (7): 816–822.

  2. 2

    Pardo-López D, Francés-Muñoz E, Gallego-Pinazo R, Díaz-Llopis M . Anterior chamber migration of dexametasone intravitreal implant (Ozurdex®). Graefes Arch Clin Exp Ophthalmol 2012; 250 (11): 1703–1704.

  3. 3

    Haller JA, Bandello F, Belfort R Jr, Blumenkranz MS, Gillies M, Heier J et alOZURDEX GENEVA Study Group. Randomized, sham-controlled trial of dexamethasone intravitreal implant in patients with macular edema due to retinal vein occlusion. Ophthalmology 2010; 117 (6): 1134–1146.e3.

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Acknowledgements

All the authors conceived and designed the work that led to the submission, acquired data, playing an important role in interpreting the results, drafted the manuscript and approved the final version.

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Correspondence to P Hernández-Martínez.

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The authors declare no conflict of interest.

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