Intravitreal Dexamethasone Implant Plus Prompt Grid Laser for Macular Edema Due to Retinal Vein Occlusion

Purpose: To evaluate the use of intravitreal dexamethasone implant followed by prompt grid laser for macular edema secondary to retinal vein occlusion (RVO).

Methods: Prospective, non-controlled, 12-month interventional case series of fifteen patients with vision loss due to macular edema secondary to RVO. Patients received an intravitreal injection with a 0.7mg dexamethasone implant followed by prompt macular grid laser within 2-4 weeks. Retreatment was offered in 3-month intervals. Primary outcome measures were change in mean log MAR best-corrected visual acuity (BCVA) and central macular thickness (CMT) at 12 months. Secondary outcome was safety at 12 months.

Results: Fifteen eyes of fifteen patients (7 BRVO and 8 CRVO) were evaluated in the case series. The baseline mean log MAR BCVA of all patients was 1.14±0.71 with a significant improvement to 0.70±0.65 (p<0.01) at month 12. Patients had a baseline mean CMT of 513.6±168.5 µm with a significant improvement to 300.2±104.1 µm (p<0.01) at month 12. Safety analysis demonstrated three patients with an increase in IOP>10 mmHg and four patients with cataract progression.

Conclusions: Intravitreal dexamethasone implant followed by prompt grid laser appears to be potentially safe and efficacious for treatment of select patients with macular edema secondary to RVO and should be considered as a treatment option, particularly in patients recalcitrant to monotherapy.