Recalcitrant Macular Edema after Pseudophakic Rhegmatogenous Retinal Detachment Repair: Risk Factors and Response to Intravitreal Dexamethasone Implant.

IF 2.1 4区 医学 Q2 OPHTHALMOLOGY
Ophthalmologica Pub Date : 2025-02-26 DOI:10.1159/000543749
Francesco Pignatelli, Alfredo Niro, Pasquale Viggiano, Giacomo Boscia, Gianluca Besozzi, Cristiana Iaculli, Giuseppe Addabbo, Francesco Boscia, Ermete Giancipoli
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引用次数: 0

Abstract

Introduction: The aim of the study was to evaluate risk factors for recalcitrance to topical therapy of post-surgical macular edema (PSME) after rhegmatogenous retinal detachment (RRD) repair and its response to intravitreal dexamethasone implant (DEX-I).

Methods: This two-center retrospective study reviewed the charts of pseudophakic patients who had undergone vitrectomy for RRD and experienced PSME within 6 months of surgery. A regression model analyzed the relationship between the recalcitrance of PSME to topical therapy and independent variables, including clinical data, surgical steps, and OCT parameters recorded at 1 month after surgery. The best-corrected visual acuity (BCVA) and central macular thickness (CMT) of eyes with responsive and recalcitrant PSME to topical therapy, the latest treated with DEX-I, were compared over follow-up.

Results: Of the 361 eyes screened, 42 (11.7%) experienced PSME. Among those, all the eyes with recalcitrant PSME (21/42) received at least one DEX-I (1.38 ± 0.49 implant). The mean follow-up was 11.9 ± 0.3 months. Disrupted retinal outer layers (p = 0.02) and hyperreflective foci (HRF) (p = 0.01) were linked to recalcitrant PSME. An increased risk for recalcitrance was observed in the presence of HRF (OR: 7.69; IC: 1.31-44.9; p = 0.02). Over follow-up, BCVA and CMT were significantly (p < 0.01) worse in implanted eyes that experienced the more significant fluctuation of CMT (189.2 ± 104.7 µm (range: 58-409 µm); p < 0.01) with a reimplant rate of 42.8%. No one of the implanted eyes experienced ocular hypertension requiring intervention or other complications.

Conclusion: HRF were found to be a risk factor for recalcitrance to topical therapy of PSME. Limited response to DEX-I was observed in such cases.

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来源期刊
Ophthalmologica
Ophthalmologica 医学-眼科学
CiteScore
5.10
自引率
3.80%
发文量
39
审稿时长
3 months
期刊介绍: Published since 1899, ''Ophthalmologica'' has become a frequently cited guide to international work in clinical and experimental ophthalmology. It contains a selection of patient-oriented contributions covering the etiology of eye diseases, diagnostic techniques, and advances in medical and surgical treatment. Straightforward, factual reporting provides both interesting and useful reading. In addition to original papers, ''Ophthalmologica'' features regularly timely reviews in an effort to keep the reader well informed and updated. The large international circulation of this journal reflects its importance.
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