Issue: June 2018
June 21, 2018
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Early VA gain predictive of visual response after dexamethasone treatment

Issue: June 2018
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Early visual acuity gain of 10 or more letters was predictive of a sustained response at 24 months after intravitreal dexamethasone treatment of macular edema in patients with retinal vein occlusion, according to a study.

The 24-month, retrospective, multinational study included 155 eyes with macular edema secondary to either central retinal vein occlusion (CRVO, 65 eyes) or branch retinal vein occlusion (BRVO, 90 eyes). The eyes were treated with dexamethasone implant and followed over 24 months. Mean BCVA for all eyes at baseline was 0.52 logMAR and mean CST was 576 m.

Jay Chhablani, MD, a co-author of the study, told Healio.com/OSN: “Clinical baseline characteristics and the early treatment response at 2 months after the first dexamethasone implant were identified as possible predictors for long-term outcome (24-month outcome) and the need [for] adjunctive intravitreal therapy.”

When patients were stratified by visual acuity gain, 37 of 67 (55.2%) patients who gained 10 or more letters at 2 months sustained that gain at 24 months (P < .001). Of the 52 patients who gained 5 letters or less at 2 months, 34 (65.4%) “remained nonresponsive,” according to the study, maintaining the 5-letter or less gain through follow-up.

There was no need for adjunctive intravitreal therapy after the first dexamethasone implant in 38 eyes (24.5%). Compared with eyes needing further therapy, these eyes were characterized as having better BCVA gain at 24 months (P = .001), being treatment-naive (P = .006) and having a baseline central subfield thickness of 400 m or less (P = .02). – by Robert Linnehan

Disclosures: The authors report no relevant financial disclosures.