Dexamethasone Intravitreal Implant for Early Treatment and Retreatment of Macular Edema Related to Branch Retinal Vein Occlusion: The Multicenter COBALT Study

Abstract

Purpose: To evaluate the effect of dexamethasone intravitreal implant for macular edema (ME) following branch retinal vein occlusion (BRVO) in Korean patients.

Methods: We performed a prospective, open-label, multicenter study of 71 patients with ME for < 3 months. Retreatment was allowed ≥4 months from the last injection.

Results: At 6 and 12 months, mean ± SD best-corrected visual acuity (BCVA) improvement was 18.6 ± 12.9 and 15.3 ± 15.0 letters, respectively. Approximately 70% of maximum treatment response was observed after 1 week. Over the 12-month period, 32 and 49% of patients received 1 and 3 injections, respectively, with a mean ± SD interval of 20.0 ± 5.0 weeks. Patients who required 3 injections had higher central retinal thickness (CRT) and larger macular nonperfusion at baseline compared to those requiring only 1 injection. Adverse events included increased intraocular pressure (35%) and newly diagnosed cataract (16%).

Conclusions: Intravitreal dexamethasone treatment with an interval of ≥4 months provides rapid and significantly better improvement in BCVA and CRT in patients with BRVO-associated ME.

Keywords: Dexamethasone implant; Early treatment; Macular edema; Retinal vein occlusion.

© 2018 The Author(s) Published by S. Karger AG, Basel.

Figures

Fig. 1

Mean change in BCVA from baseline at each visit. BCVA, best-corrected visual acuity; M, month(s); W, week.

Fig. 2

Mean change in CRT from baseline at each visit. CRT, central retinal thickness; M, month(s); W, week.

Fig. 3

Percentage of patients with an IOP change of ≥10 mm Hg from baseline (a) and IOP of ≥25 mm Hg (b). IOP, intraocular pressure; M, month(s); W, week.

Fig. 4

Percentage of patients by number of topical IOP-lowering medications. IOP, intraocular pressure; M, month(s); med, medication; W, week.