Efficacy of Ozurdex implants as second-line therapy for non-responders to anti-VEGF in retinal vein occlusion-associated macular edema: a retrospective cohort study.

Abstract

Purpose: Retinal vein occlusion (RVO) is a prevalent retinal vascular disorder characterized by retinal haemorrhage, neovascularization, and macular edema This study aimed to assess the structural and functional effects of intravitreal implant (Ozurdex) treatment as a second-line for RVO-associated macular edema in patients who did not respond to first-line anti-VEGF therapy.

Materials and methods: We conducted a retrospective observational cohort study using electronic health records of RVO patients at Salisbury District Hospital between January 2014 and December 2019. Inclusion criteria included patients diagnosed with central or branch RVO. Patients underwent ophthalmic evaluations at baseline, including central retinal thickness (CRT) and best-corrected visual acuity (BCVA) assessments. Statistical analysis was performed using IBM SPSS Statistics, employing various tests to determine significance.

Results: Sixteen eyes of 16 White British patients were evaluated. Most patients had branch RVO (52.95%), and 47.05% had central RVO. While anti-VEGF treatment significantly improved BCVA (p = 0.0061), Ozurdex did not result in additional gain (p = 0.747). Both treatments significantly reduced CRT (p = 0.0055 for anti-VEGF; p = 0.0079 for Ozurdex). No significant differences were observed between diabetic and non-diabetic BCVA patients receiving either treatment.

Conclusion: Ozurdex emerges as a safe and effective option for persistent macular edema in RVO patients unresponsive to anti-VEGF therapy. Although structural improvements in CRT were observed following Ozurdex treatment, they did not correlate with additional gain in BCVA. Despite this, the reduced treatment frequency of Ozurdex compared to anti-VEGF injections may be advantageous, particularly for frail non-responding patients minimizing treatment burden.