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Macular oedema secondary to rhegmatogenous retinal detachment repair: risk factors for resistance to first-line therapy and long-term response to dexamethasone intravitreal implant

Eye volume 38, pages 1155–1161 (2024)Cite this article

Subjects

Abstract

Objectives

To assess the risk factors for resistance to first-line therapy and long-term response to dexamethasone intravitreal implant (Ozurdex®) of patients with macular oedema (MO) secondary to rhegmatogenous retinal detachment repair (RRDR).

Methods

This was a retrospective, consecutive cohort study conducted in patients who underwent RRDR between January 2014 and December 2020 in the Rothschild Foundation Hospital and experienced postoperative MO (POMO) with a follow-up of at least 18 months.

Results

Of the 1152 patients screened, 36 eyes (3.1%) experienced POMO. The mean follow-up duration was 45.2 months (18.0–80.5 months). Twenty-five eyes (69.4%) were resistant to first-line therapy and received at least one Ozurdex® injection (mean number: 2.7 [1–12]). The multivariate analysis showed an increased risk of resistance in patients who underwent perfluorocarbon liquid (PFCL)-assisted drainage (adjusted odds ratio: 8.65; 95% confidence interval: 1.97–15.33; p = 0.01). Significant differences in best-corrected visual acuity and central macular thickness were found between before Ozurdex® injection and the last follow-up visit: from 0.57 ± 0.47 LogMAR to 0.34 ± 0.32 LogMAR (p = 0.02) and from 483.0 ± 124.0 µm to 354.6 ± 96.5 µm (p = 0.001), respectively. The absence of serous retinal detachment and the presence of hyperreflective foci at baseline were associated with a higher resistance and a poorer response to Ozurdex®. Two patients (8%) experienced hypertony, that was well controlled with hypotonic drops.

Conclusion

MO secondary to RRDR is challenging. Ozurdex® could be reasonably proposed as first-line treatment, at least when MO occurs following PFCL-assisted drainage, given the favourable long-term benefit/risk ratio.

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Fig. 1
Fig. 2
Fig. 3: SD-OCT macular scans of a 74-year-old phakic patient who experienced macular oedema after initial rhegmatogenous retinal detachment repair.
Fig. 4: SD-OCT macular scans of a 61-year-old pseudophakic patient with relapsing rhegmatogenous retinal detachment.

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Data availability

The data that support the findings of this study are available from the corresponding author, SS, upon reasonable request.

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Authors and Affiliations

  1. Department of Vitreoretinal Surgery, Rothschild Foundation Hospital, 25-29 rue Manin, 75019, Paris, France

    Soufiane Souissi, Violaine Allou, Laura Trucchi, Yannick Le Mer & Ramin Tadayoni

  2. Department of Ophthalmology, Lariboisière Hospital, 2 rue Ambroise Paré, 75010, Paris, France

    Ramin Tadayoni & Aude Couturier

Authors
  1. Soufiane Souissi
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  2. Violaine Allou
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  3. Laura Trucchi
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  4. Yannick Le Mer
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  5. Ramin Tadayoni
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  6. Aude Couturier
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Contributions

SS, RT, AC: design. SS, VA, LT, YLM, RT, AC: Conduct of the study. SS, VA, LT: Collection. SS, RT, YLM, AC: Management. SS, VA: Analysis. SS, VA, LT: Interpretation of the data. SS, VA: Preparation. SS, YLM, RT, AC: Review. SS, AC: approval of the manuscript.

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Correspondence to Soufiane Souissi.

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Souissi, S., Allou, V., Trucchi, L. et al. Macular oedema secondary to rhegmatogenous retinal detachment repair: risk factors for resistance to first-line therapy and long-term response to dexamethasone intravitreal implant. Eye 38, 1155–1161 (2024). https://doi.org/10.1038/s41433-023-02852-x

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