Purpose: To report our results concerning the safety and efficacy of repeated sustainedrelease
dexamethasone 0.7 mg implants (Ozurdex, Allergan, Inc., Irvine, CA) in patients with
persistent Macular Edema (ME) due to Retinal Vein Occlusion (RVO) previously treated with anti-
Patients and Methods: Ten patients (5 males and 5 females/ 5 with CRVO and 5 with BRVO), all
previously treated with at least 3 consecutive anti- VEGF injections and presented lack of anatomic
improvement (CRT >250μm in OCT) accompanied by lack of visual improvement (no change or
deterioration of VA), received one or more Ozurdex injections (up to five). Ozurdex was administrated
on an ‘as needed’ regimen and patients underwent a complete ophthalmological examination, including Best Corrected
Visual Acuity (BCVA) measurements, biomicroscopy, tonometry, and Fourier Domain Optical Coherence Tomography
(FD-OCT) on a monthly basis. Furthermore, mean time intervals for OZURDEX re-injection were estimated.
Results: In 9 out of 10 cases, the patients experienced improvement in BCVA after the Ozurdex implantation with
reduction in CRT. The most frequently observed adverse events included IOP elevation (20% of cases), cataract
progression (10%) and cataract formation (10%). No serious systemic or topical adverse events were observed in eyes
undergoing repeated Ozurdex implantations. In one of the patients, it was observed that the implant was fractured into two
pieces without affecting the efficacy of the implant or causing any side effects.
Conclusion: Provided the complexity of molecular mechanisms involved in ΜΕ development and the effect of
corticosteroids on many of these mechanisms, in our case series, Ozurdex appeared to be a safe and beneficial treatment
option for persistent ME due to RVO, in patients with poor or complete lack of response after at least 3 consecutive
monthly intravitreal anti-VEGF injections. The complication rate of cataract reported in our study is relatively high
compared to previous reports. This might be attributed to the multiple injections, as the incidence of cataract increases
with time. Regarding IOP elevation, there is no consensus among published clinical trials on the percentage of patients
requiring IOP-lowering medications. Further studies with a greater patient population as well as a control group are
required in order to confirm our findings.