Does Ozurdex affect perfusion status in vein occlusion?
Reviewed by Eulee Seow

Ozurdex (intravitreal dexamethasone implant) has been approved by National Institute of Health & Care Excellence (NICE) for treatment of patients with macular oedema associated with vein occlusion. This study looks at the change in peripheral perfusion status in patients with retinal vein occlusion (RVO) during dexamethasone treatment. Thirty-five eyes of patients were included and followed-up for six months. Wide‐field angiographies were classified as ischaemic and nonischaemic. Peripheral nonperfusion (PNP) was determined manually by calculating the percentage of nonperfusion area in relation to the total visible retina (ischaemic index). Thirteen eyes showed evidence of >10 disc area of PNP at baseline and were graded as ischaemic RVO. In nonischaemic eyes, the mean area of PNP was 0.3% at baseline, 0.6% after one month, 0.6% after three months and 0.6% after six months, respectively (p > 0.05). In ischaemic RVO, the ischaemic index was calculated to be 18% at baseline. One month after treatment, mean area of PNP was 16% and after three months was 19% (p=0.8; p=0.6). After retreatment, total PNP area was 18% (month six; p=0.9). During treatment, best‐corrected visual acuity (BCVA) increased and central retinal thickness (CRT) decreased from baseline to final follow‐up with no differences between nonischaemic / ischaemic RVO. A significant negative correlation between the total area of PNP and visual acuity was identified (r=−0.6; p=0.04). Using 200 wide‐field fluorescein angiography, the ischaemic index was shown to remain stable during dexamethasone treatment. This finding was consistent in ischaemic as well as in nonischaemic conditions.

Extension of peripheral nonperfusion in eyes with retinal vein occlusion during intravitreal dexamethasone treatment.
Rezar‐Dreindl S, Eibenberger K, Buehl W, et al.
ACTA OPHTHALMOLOGICA
2018;96:e455-e9.