Intravitreal Dexamethasone Implantation in Intravitreal Bevacizumab Treatment-Resistant Pseudophakic Cystoid Macular Edema
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Purpose: To evaluate the changes in visual acuity (VA) and central macular thickness (CMT) after intravitrealdexamethasone (IVD) implantation in intravitreal bevacizumab (IVB) treatment-resistant cases with pseudophakiccystoid macular edema (PCME). Methods: This study included 10 PCME cases who underwent uneventful phacoemulsification and intraocularlens implantation with similar methods and six PCME cases referred to our hospital for treatment oflow VA after cataract surgery. Due to the persistence of PCME, both topical steroid and anti-inflammatorymedication were administered first, followed by IVB injection. IVD implantation was performed for all IVBtreatment-resistant cases. VA and CMT values were compared before and at three months after the first IVDimplantation. Results: The mean VA values before and at 3 months after the first IVD implantation were 0.69 ± 0.19 logarithmof the minimum angle of resolution (logMAR) (1.50 to 0.10 logMAR) and 0.26 ± 0.07 logMAR (1.00 to 0.00logMAR), respectively (p < 0.001). The mean CMT was 476.13 ± 135.13 mm (314 to 750 mm) and 294.06 ±15.26 mm (222 to 480 mm), respectively (p < 0.001). The mean number of implanted IVD was 1.44 ± 0.89 (1to 4) and the mean follow-up time was 7.4 ± 4.6 months (6 to 24 months). After IVD implantation therapy, themean VA and CMT values were 0.19 ± 0.05 logMAR (0.70 to 0.00 logMAR) and 268.38 ± 31.35 mm (217 to351 mm), respectively. Conclusions: To the best of our knowledge, this is the first report to show the efficacy of IVD implantationeven after repeated IVB injections in treatment-resistant PCME. IVD implantation is both a safe and effectivemethod for decreasing PCME after both uneventful and complicated cataract surgery.
Abstract
Purpose: To evaluate the changes in visual acuity (VA) and central macular thickness (CMT) after intravitrealdexamethasone (IVD) implantation in intravitreal bevacizumab (IVB) treatment-resistant cases with pseudophakiccystoid macular edema (PCME). Methods: This study included 10 PCME cases who underwent uneventful phacoemulsification and intraocularlens implantation with similar methods and six PCME cases referred to our hospital for treatment oflow VA after cataract surgery. Due to the persistence of PCME, both topical steroid and anti-inflammatorymedication were administered first, followed by IVB injection. IVD implantation was performed for all IVBtreatment-resistant cases. VA and CMT values were compared before and at three months after the first IVDimplantation. Results: The mean VA values before and at 3 months after the first IVD implantation were 0.69 ± 0.19 logarithmof the minimum angle of resolution (logMAR) (1.50 to 0.10 logMAR) and 0.26 ± 0.07 logMAR (1.00 to 0.00logMAR), respectively (p < 0.001). The mean CMT was 476.13 ± 135.13 mm (314 to 750 mm) and 294.06 ±15.26 mm (222 to 480 mm), respectively (p < 0.001). The mean number of implanted IVD was 1.44 ± 0.89 (1to 4) and the mean follow-up time was 7.4 ± 4.6 months (6 to 24 months). After IVD implantation therapy, themean VA and CMT values were 0.19 ± 0.05 logMAR (0.70 to 0.00 logMAR) and 268.38 ± 31.35 mm (217 to351 mm), respectively. Conclusions: To the best of our knowledge, this is the first report to show the efficacy of IVD implantationeven after repeated IVB injections in treatment-resistant PCME. IVD implantation is both a safe and effectivemethod for decreasing PCME after both uneventful and complicated cataract surgery.
참고문헌 (29)
- Yonekawa Y, "Pseudophakic cystoid macular edema", Curr Opin Ophthalmol, 23, pp.26~32 (2012)
- Gass JD, "Cystoid macular edema and papilledema following cataract extraction : a fluorescein fundoscopic and angiographic study", Arch Ophthalmol, 76, pp.646~661 (1966)
- Schubert HD, "Cystoid macular edema : the apparent role of mechanical factors", Prog Clin Biol Res, 312, pp.277~291 (1989)
- Ursell PG, "Cystoid macular edema after phacoemulsification : relationship to blood-aqueous barrier damage and visual acuity", J Cataract Refract Surg, 25, pp.1492~1497 (1999)
- Henderson BA, "Clinical pseudophakic cystoid macular edema. Risk factors for development and duration after treatment", J Cataract Refract Surg, 33, pp.1550~1558 (2007)
- Eriksson U, "Macular edema and visual outcome following cataract surgery in patients with diabetic retinopathy and controls", Graefes Arch Clin Exp Ophthalmol, 249, pp.349~359 (2011)
- Chu CJ, "Risk factors and incidence of macular edema after cataract surgery : a database study of 81984 eyes", Ophthalmology, 123, pp.316~323 (2016)
- Sacconi R, "Optical coherence tomography angiography in pseudophakic cystoid macular oedema compared to diabetic macular oedema : qualitative and quantitative evaluation of retinal vasculature", Br J Ophthalmol, 102, pp.1684~1690 (2018)
- Benitah NR, "Pseudophakic cystoid macular edema", Int Ophthalmol Clin, 50, pp.139~153 (2010)
- Vukicevic M, "Prevalence of optical coherence tomography-diagnosed postoperative cystoid macular oedema in patients following uncomplicated phaco-emulsification cataract surgery", Clin Exp Ophthalmol, 40, pp.282~287 (2012)
- Altintas AG, "Comparison of phaco parameters effect on macular thickness changes after uneventful phacosurgery in diabetic and non-diabetic patients", Int Eye Sci, 16, pp.201~206 (2016)
- Lin CJ, "Use of aflibercept for the management of refractory pseudophakic macular edema in Irvine-Gass syndrome and literature review", Retin Cases Brief Rep, 12, pp.59~62 (2018)
- Kiernan DF, "Controversies in the management of Irvine-Gass syndrome", Ophthalmic Surg Lasers Imaging Retina, 44, pp.522~527 (2013)
- Randazzo A, "Chronic macular edema medical treatment in Irvine-Gass syndrome : case report", Eur J Ophthalmol, 20, pp.462~465 (2010)
- Ilhan C, "Current developments in monofocal intraocular lens technology", Int J Ophthalmic Res, 3, pp.239~242 (2017)
- Lobo CL, "Macular alterations after small-incision cataract surgery", J Cataract Refract Surg, 30, pp.752~760 (2004)
- Hudes GR, "Prostacyclin is the major prostaglandin synthesized by bovine retinal capillary pericytes in culture", Invest Ophthalmol Vis Sci, 29, pp.1511~1516 (1988)
- Shelsta HN, "Pharmacologic therapy of pseudophakic cystoid macular edema : 2010 update", Retina, 31, pp.4~12 (2011)
- Brynskov T, "Longstanding refractory pseudophakic cystoid macular edema resolved using intravitreal 0.7 mg dexamethasone implants", Clin Ophthalmol, 7, pp.1171~1174 (2013)
- Dang Y, "Comparison of dexamethasone intravitreal implant and intravitreal triamcinolone acetonide for the treatment of pseudophakic cystoid macular edema in diabetic patients", Drug Des Devel Ther, 8, pp.1441~1449 (2014)
- Garcia JM, "Dexamethasone 0.7 mg implants in the management of pseudophakic cystoid macular edema", Arq Bras Oftalmol, 79, pp.113~115 (2016)
- Kakkassery V, "Evaluation of predictive factors for successful intravitreal dexamethasone in pseudophakic cystoid macular edema", J Ophthalmol, 2017, pp.4625730~ (2017)
- Mayer WJ, "Dexamethasone implant as an effective treatment option for macular edema due to Irvine-Gass syndrome", J Cataract Refract Surg, 41, pp.1954~1961 (2015)
- Dutra Medeiros M, "Dexamethasone intravitreal implant for treatment of patients with recalcitrant macular edema resulting from Irvine-Gass syndrome", Invest Ophthalmol Vis Sci, 54, pp.3320~3324 (2013)
- Tolentino MJ, "Pathologic features of vascular endothelial growth factor-induced retinopathy in the nonhuman primate", Am J Ophthalmol, 133, pp.373~385 (2002)
- Arevalo JF, "Intravitreal bevacizumab for refractory pseudophakic cystoid macular edema : the Pan-American Collaborative Retina Study Group results", Ophthalmology, 116, pp.1481~1487 (2009)
- Mason JO 3rd, "Intravitreal bevacizumab(Avastin)for refractory pseudophakic cystoid macular edema", Retina, 26, pp.356~357 (2006)
- Barone A, "Successful treatment of pseudophakic cystoid macular edema with intravitreal bevacizumab", J Cataract Refract Surg, 34, pp.1210~1212 (2008)
- Spitzer MS, "Efficacy of intravitreal bevacizumab in treating postoperative pseudophakic cystoid macular edema", J Cataract Refract Surg, 34, pp.70~75 (2008)