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Evaluation of Predictive Factors for Successful Intravitreal Dexamethasone in Pseudophakic Cystoid Macular Edema

PURPOSE: To determine the efficacy, safety, and predictive outcome factors for intravitreal dexamethasone implant (DEX) in pseudophakic cystoid macular edema (PCME). METHODS: Retrospective, interventional, controlled study. Patients included had to have clinically significant PCME and have been trea...

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Autores principales: Kakkassery, Vinodh, Schultz, Tim, Wunderlich, Marc Ilan, Schargus, Marc, Dick, H. Burkhard, Rehrmann, Jörg
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Hindawi 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5749279/
https://www.ncbi.nlm.nih.gov/pubmed/29410912
http://dx.doi.org/10.1155/2017/4625730
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author Kakkassery, Vinodh
Schultz, Tim
Wunderlich, Marc Ilan
Schargus, Marc
Dick, H. Burkhard
Rehrmann, Jörg
author_facet Kakkassery, Vinodh
Schultz, Tim
Wunderlich, Marc Ilan
Schargus, Marc
Dick, H. Burkhard
Rehrmann, Jörg
author_sort Kakkassery, Vinodh
collection PubMed
description PURPOSE: To determine the efficacy, safety, and predictive outcome factors for intravitreal dexamethasone implant (DEX) in pseudophakic cystoid macular edema (PCME). METHODS: Retrospective, interventional, controlled study. Patients included had to have clinically significant PCME and have been treated with the DEX between 2012 and 2015. Charts and one-year data were selected consecutively, and efficacy and safety were abstracted. Visual acuity (VA) and central foveal thickness (CFT) were analysed. RESULTS: Nineteen patient data sets were analysed. After treatment with DEX, mean VA increased significantly by 0.2 logMAR (p = 0.034), while the mean CFT was reduced significantly by 162.79 μm (p < 0.001). Five patients receiving a combination of DEX/bevacizumab have not experienced a higher mean VA gain or CFT reduction compared to fourteen patients receiving DEX alone. Decision rules, when to combine DEX with bevacizumab, have not been defined before the study. Only posttreatment VA gains in the nonhypertensive subgroup (n = 11) were significantly better (p = 0.026). Analysis of data from diabetes patients (n = 4) versus nondiabetics yielded no significant differences in efficacy. There have been no adverse events within follow-up time. CONCLUSION: The use of DEX in PCME showed significant improvements in VA and CFT. The VA seems to show greater improvements in patients without hypertension.
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spelling pubmed-57492792018-02-06 Evaluation of Predictive Factors for Successful Intravitreal Dexamethasone in Pseudophakic Cystoid Macular Edema Kakkassery, Vinodh Schultz, Tim Wunderlich, Marc Ilan Schargus, Marc Dick, H. Burkhard Rehrmann, Jörg J Ophthalmol Research Article PURPOSE: To determine the efficacy, safety, and predictive outcome factors for intravitreal dexamethasone implant (DEX) in pseudophakic cystoid macular edema (PCME). METHODS: Retrospective, interventional, controlled study. Patients included had to have clinically significant PCME and have been treated with the DEX between 2012 and 2015. Charts and one-year data were selected consecutively, and efficacy and safety were abstracted. Visual acuity (VA) and central foveal thickness (CFT) were analysed. RESULTS: Nineteen patient data sets were analysed. After treatment with DEX, mean VA increased significantly by 0.2 logMAR (p = 0.034), while the mean CFT was reduced significantly by 162.79 μm (p < 0.001). Five patients receiving a combination of DEX/bevacizumab have not experienced a higher mean VA gain or CFT reduction compared to fourteen patients receiving DEX alone. Decision rules, when to combine DEX with bevacizumab, have not been defined before the study. Only posttreatment VA gains in the nonhypertensive subgroup (n = 11) were significantly better (p = 0.026). Analysis of data from diabetes patients (n = 4) versus nondiabetics yielded no significant differences in efficacy. There have been no adverse events within follow-up time. CONCLUSION: The use of DEX in PCME showed significant improvements in VA and CFT. The VA seems to show greater improvements in patients without hypertension. Hindawi 2017 2017-12-19 /pmc/articles/PMC5749279/ /pubmed/29410912 http://dx.doi.org/10.1155/2017/4625730 Text en Copyright © 2017 Vinodh Kakkassery et al. http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Kakkassery, Vinodh
Schultz, Tim
Wunderlich, Marc Ilan
Schargus, Marc
Dick, H. Burkhard
Rehrmann, Jörg
Evaluation of Predictive Factors for Successful Intravitreal Dexamethasone in Pseudophakic Cystoid Macular Edema
title Evaluation of Predictive Factors for Successful Intravitreal Dexamethasone in Pseudophakic Cystoid Macular Edema
title_full Evaluation of Predictive Factors for Successful Intravitreal Dexamethasone in Pseudophakic Cystoid Macular Edema
title_fullStr Evaluation of Predictive Factors for Successful Intravitreal Dexamethasone in Pseudophakic Cystoid Macular Edema
title_full_unstemmed Evaluation of Predictive Factors for Successful Intravitreal Dexamethasone in Pseudophakic Cystoid Macular Edema
title_short Evaluation of Predictive Factors for Successful Intravitreal Dexamethasone in Pseudophakic Cystoid Macular Edema
title_sort evaluation of predictive factors for successful intravitreal dexamethasone in pseudophakic cystoid macular edema
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5749279/
https://www.ncbi.nlm.nih.gov/pubmed/29410912
http://dx.doi.org/10.1155/2017/4625730
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