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RECALCITRANT MACULAR EDEMA AFTER INTRAVITREAL BEVACIZUMAB IS RESPONSIVE TO AN INTRAVITREAL DEXAMETHASONE IMPLANT IN RETINAL VEIN OCCLUSION

Sharareh, Behnam BS*,†; Gallemore, Ron MD, PhD*; Taban, Mehran MD*; Onishi, Spencer BS*; Wallsh, Josh BS*

doi: 10.1097/IAE.0b013e31827c53a0
Original Studies

Purpose: To test the efficacy of an intravitreal dexamethasone implant in patients with recalcitrant macular edema secondary to retinal vein occlusion.

Methods: A retrospective chart review was performed for 18 patients with retinal vein occlusion who received multiple bevacizumab intravitreal injections before treatment with an intravitreal dexamethasone implant.

Results: Two subgroups of bevacizumab-resistant patients were identified. Both subgroups responded to subsequent treatment with an intravitreal dexamethasone implant with an average reduction in central foveal thickness of 146.8 ± 33.65 μm. A visual acuity improvement of 0.26 ± 0.07 (logarithm of minimal angle of resolution) was also noted. Intraocular pressure increased by an average of 3.33 ± 0.66 mmHg and was managed by 1.0 ± 0.5 topical drops.

Conclusion: A subset of patients do not have resolution of macular edema after treatment with intravitreal bevacizumab. Such patients may respond to treatment with an intravitreal dexamethasone implant.

Residual macular edema after intravitreal bevacizumab in retinal vein occlusion is reduced by subsequent intravitreal dexamethasone implant injection. This implant should be considered in such recalcitrant cases.

*Retina Macula Institute, Torrance, California

University of California, Irvine, School of Medicine, Irvine, California.

The authors have no conflicts of interest to disclose.

Reprint requests: Ron Gallemore, MD, PhD, Retina Macula Institute, 4201 Torrance Boulevard, Suite 220, Torrance, CA 90503; e-mail: rongallemoremd@gmail.com

© 2013 by Ophthalmic Communications Society, Inc.