Dexamethasone Intravitreal Implant for the Treatment of Macular Edema and Uveitis: A Comprehensive Narrative Review

References

• Nauck M, Karakiulakis G, Perruchoud AP, et al. Corticosteroids inhibit the expression of the vascular endothelial growth factor gene in human vascular smooth muscle cells. Eur J Pharmacol. 1998;341(2–3):309–315. doi:10.1016/S0014-2999(97)01464-7
   PubMed Web of Science ®Google Scholar
• Penfold PL, Wen L, Madigan MC, et al. Triamcinolone acetonide modulates permeability and intercellular adhesion molecule-1 (ICAM-1) expression of the ECV304 cell line: implications for macular degeneration. Clin Exp Immunol. 2000;121(3):458–465. doi:10.1046/j.1365-2249.2000.01316.x
   PubMed Web of Science ®Google Scholar
• Singer KL, Stevenson BR, Woo PL, et al. Relationship of serine/threonine phosphorylation/dephosphorylation signaling to glucocorticoid regulation of tight junction permeability and ZO-1 distribution in nontransformed mammary epithelial cells. J Biol Chem. 1994;269(23):16108–16115.
   PubMed Web of Science ®Google Scholar
• Antonetti DA, Wolpert EB, DeMaio L, et al. Hydrocortisone decreases retinal endothelial cell water and solute flux coincident with increased content and decreased phosphorylation of occludin. J Neurochem. 2002;80(4):667–677. doi:10.1046/j.0022-3042.2001.00740.x
   PubMed Web of Science ®Google Scholar
• Edelman JL, Lutz D, Castro MR. Corticosteroids inhibit VEGF-induced vascular leakage in a rabbit model of blood-retinal and blood-aqueous barrier breakdown. Exp Eye Res. 2005;80(2):249–258. doi:10.1016/j.exer.2004.09.013
   PubMed Web of Science ®Google Scholar
• Graham RO, Peyman GA. Intravitreal injection of dexamethasone. treatment of experimentally induced endophthalmitis. Arch Ophthalmol. 1974;92(2):149–154. doi:10.1001/archopht.1974.01010010155016
   PubMedGoogle Scholar
• Kwak HW, D’Amico DJ. Evaluation of the retinal toxicity and pharmacokinetics of dexamethasone after intravitreal injection. Arch Ophthalmol. 1992;110(2):259–266. doi:10.1001/archopht.1992.01080140115038
   PubMed Web of Science ®Google Scholar
• Chang-Lin J, Attar M, Acheampong AA, et al. Pharmacokinetics and pharmacodynamics of a sustained-release dexamethasone intravitreal implant. Invest Ophthalmol Vis Sci. 2011;52(1):80–86. doi:10.1167/iovs.10-5285
   PubMed Web of Science ®Google Scholar
• Chang-Lin J, Burke JA, Peng Q, et al. Pharmacokinetics of a sustained-release dexamethasone intravitreal implant in vitrectomized and nonvitrectomized eyes. Invest Ophthalmol Vis Sci. 2011;52(7):4605–4609. doi:10.1167/iovs.10-6387
   PubMed Web of Science ®Google Scholar
• Khurana RN, Bansal AS, Chang LK, et al. Prospective evaluation of a sustained-release dexamethasone intravitreal implant for cystoid macular edema in quiescent uveitis. Retina. 2017;37(9):1692–1699. doi:10.1097/IAE.0000000000001406
   PubMed Web of Science ®Google Scholar
• Available from: https://media.allergan.com/actavis/actavis/media/allergan-pdf-documents/product-prescribing/20180515-OZURDEX-USPI-v1-0USPI3348.pdf. Accessed March 10, 2022.
   Google Scholar
• Rogers S, McIntosh RL, Cheung N, et al. The prevalence of retinal vein occlusion: pooled data from population studies from the United States, Europe, Asia, and Australia. Ophthalmology. 2010;117(2):313,319.e1. doi:10.1016/j.ophtha.2009.07.017
   Web of Science ®Google Scholar
• Mitchell P, Smith W, Chang A. Prevalence and associations of retinal vein occlusion in Australia: the blue mountains eye study . Arch Ophthalmol. 1996;114(10):1243–1247.
   PubMed Web of Science ®Google Scholar
• Ehlers JP, Fekrat S. Retinal vein occlusion: beyond the acute event. Surv Ophthalmol. 2011;56(4):281–299. doi:10.1016/j.survophthal.2010.11.006
   PubMed Web of Science ®Google Scholar
• O’Mahoney PRA, Wong DT, Ray JG. Retinal vein occlusion and traditional risk factors for atherosclerosis. Arch Ophthalmol. 2008;126(5):692–699. doi:10.1001/archopht.126.5.692
   PubMedGoogle Scholar
• Janssen MCH, den Heijer M, Cruysberg JRM, et al. Retinal vein occlusion: a form of venous thrombosis or a complication of atherosclerosis? A meta-analysis of thrombophilic factors. Thromb Haemost. 2005;93(6):1021–1026. doi:10.1160/TH04-11-0768
   PubMed Web of Science ®Google Scholar
• Bucciarelli P, Passamonti SM, Gianniello F, et al. Thrombophilic and cardiovascular risk factors for retinal vein occlusion. Eur J Intern Med. 2017;44:44–48.
   PubMed Web of Science ®Google Scholar
• Sperduto RD, Hiller R, Chew E, et al. Risk factors for hemiretinal vein occlusion: comparison with risk factors for central and branch retinal vein occlusion: the eye disease case-control study. Ophthalmology. 1998;105(5):765–771. doi:10.1016/S0161-6420(98)95012-6
   PubMed Web of Science ®Google Scholar
• CVO Study Group. Baseline and early natural history report. the central vein occlusion study. Arch Ophthalmol. 1993;111(8):1087–1095. doi:10.1001/archopht.1993.01090080083022
   PubMedGoogle Scholar
• Hayreh SS, Klugman MR, Beri M, et al. Differentiation of ischemic from non-ischemic central retinal vein occlusion during the early acute phase. Graefes Arch Clin Exp Ophthalmol. 1990;228(3):201–217. doi:10.1007/BF00920022
   PubMed Web of Science ®Google Scholar
• Branch Vein Occlusion Study Group. Argon laser scatter photocoagulation for prevention of neovascularization and vitreous hemorrhage in branch vein occlusion. A randomized clinical trial. branch vein occlusion study group. Arch Ophthalmol. 1986;104(1):34–41. doi:10.1001/archopht.1986.01050130044017
   PubMedGoogle Scholar
• Jaulim A, Ahmed B, Khanam T, et al. Branch retinal vein occlusion: epidemiology, pathogenesis, risk factors, clinical features, diagnosis, and complications. an update of the literature. Retina. 2013;33(5):901–910. doi:10.1097/IAE.0b013e3182870c15
   PubMed Web of Science ®Google Scholar
• Ascaso FJ, Huerva V, Grzybowski A. The role of inflammation in the pathogenesis of macular edema secondary to retinal vascular diseases. Mediators Inflamm. 2014;2014:432685.
   PubMed Web of Science ®Google Scholar
• CVO Study Group. Evaluation of grid pattern photocoagulation for macular edema in central vein occlusion. the central vein occlusion study group M report. Ophthalmology. 1995;102(10):1425–1433. doi:10.1016/S0161-6420(95)30849-4
   PubMed Web of Science ®Google Scholar
• Kuppermann BD, Blumenkranz MS, Haller JA, et al. Randomized controlled study of an intravitreous dexamethasone drug delivery system in patients with persistent macular edema. Arch Ophthalmol. 2007;125(3):309–317. doi:10.1001/archopht.125.3.309
   PubMed Web of Science ®Google Scholar
• Haller JA, Bandello F, Belfort R, et al. Randomized, sham-controlled trial of dexamethasone intravitreal implant in patients with macular edema due to retinal vein occlusion. Ophthalmology. 2010;117(6):1134–1146. doi:10.1016/j.ophtha.2010.03.032
   PubMed Web of Science ®Google Scholar
• Haller JA, Bandello F, Belfort R, et al. Dexamethasone intravitreal implant in patients with macular edema related to branch or central retinal vein occlusion twelve-month study results. Ophthalmology. 2011;118(12):2453–2460. doi:10.1016/j.ophtha.2011.05.014
   PubMed Web of Science ®Google Scholar
• Yeh W, Haller JA, Lanzetta P, et al. Effect of the duration of macular edema on clinical outcomes in retinal vein occlusion treated with dexamethasone intravitreal implant. Ophthalmology. 2012;119(6):1190–1198. doi:10.1016/j.ophtha.2011.12.028
   PubMed Web of Science ®Google Scholar
• Kuppermann BD, Haller JA, Bandello F, et al. Onset and duration of visual acuity improvement after dexamethasone intravitreal implant in eyes with macular edema due to retinal vein occlusion. Retina. 2014;34(9):1743–1749. doi:10.1097/IAE.0000000000000167
   PubMed Web of Science ®Google Scholar
• Li X, Wang N, Liang X, et al. Safety and efficacy of dexamethasone intravitreal implant for treatment of macular edema secondary to retinal vein occlusion in Chinese patients: randomized, sham-controlled, multicenter study. Graefes Arch Clin Exp Ophthalmol. 2018;256(1):59–69. doi:10.1007/s00417-017-3831-6
   PubMed Web of Science ®Google Scholar
• Gado AS, Macky TA. Dexamethasone intravitreous implant versus bevacizumab for central retinal vein occlusion-related macular oedema: a prospective randomized comparison. Clin Exp Ophthalmol. 2014;42(7):650–655. doi:10.1111/ceo.12311
   PubMed Web of Science ®Google Scholar
• Hoerauf H, Feltgen N, Weiss C, et al. Clinical efficacy and safety of ranibizumab versus dexamethasone for central retinal vein occlusion (COMRADE C): a European label study. Am J Ophthalmol. 2016;169:258–267.
   PubMed Web of Science ®Google Scholar
• Hattenbach L, Feltgen N, Bertelmann T, et al. Head-to-head comparison of ranibizumab PRN versus single-dose dexamethasone for branch retinal vein occlusion (COMRADE-B). Acta Ophthalmol. 2018;96(1):e10–18. doi:10.1111/aos.13381
   PubMed Web of Science ®Google Scholar
• Bandello F, Augustin A, Tufail A, et al. A 12-month, multicenter, parallel group comparison of dexamethasone intravitreal implant versus ranibizumab in branch retinal vein occlusion. Eur J Ophthalmol. 2018;28(6):697–705. doi:10.1177/1120672117750058
   PubMed Web of Science ®Google Scholar
• Chatziralli I, Theodossiadis G, Kabanarou SA, et al. Ranibizumab versus dexamethasone implant for central retinal vein occlusion: the RANIDEX study. Graefes Arch Clin Exp Ophthalmol. 2017;255(10):1899–1905. doi:10.1007/s00417-017-3719-5
   PubMed Web of Science ®Google Scholar
• Gu X, Yu X, Song S, et al. Intravitreal dexamethasone implant versus intravitreal ranibizumab for the treatment of macular edema secondary to retinal vein occlusion in a Chinese population. Ophthalmic Res. 2017;58(1):8–14. doi:10.1159/000458534
   PubMed Web of Science ®Google Scholar
• Yuksel B, Karti O, Celik O, et al. Low frequency ranibizumab versus dexamethasone implant for macular oedema secondary to branch retinal vein occlusion. Clin Exp Optom. 2018;101(1):116–122. doi:10.1111/cxo.12586
   PubMed Web of Science ®Google Scholar
• de Salles MC, Epstein D. Real-life study of the use of anti-VEGF therapy versus dexamethasone implant for treatment of macular edema in retinal vein occlusion. Graefes Arch Clin Exp Ophthalmol. 2021;259(9):2653–2660. doi:10.1007/s00417-021-05146-8
   PubMed Web of Science ®Google Scholar
• Gale R, Pikoula M, Lee AY, et al. Real world evidence on 5661 patients treated for macular oedema secondary to branch retinal vein occlusion with intravitreal anti-vascular endothelial growth factor, intravitreal dexamethasone or macular laser. Br J Ophthalmol. 2021;105(4):549–554. doi:10.1136/bjophthalmol-2020-315836
   PubMed Web of Science ®Google Scholar
• Gale R, Gill C, Pikoula M, et al. Multicentre study of 4626 patients assesses the effectiveness, safety and burden of two categories of treatments for central retinal vein occlusion: intravitreal anti-vascular endothelial growth factor injections and intravitreal ozurdex injections. Br J Ophthalmol. 2021;105(11):1571–1576. doi:10.1136/bjophthalmol-2020-317306
   PubMed Web of Science ®Google Scholar
• Manousaridis K, Peter S, Mennel S. Outcome of intravitreal dexamethasone implant for the treatment of ranibizumab-resistant macular edema secondary to retinal vein occlusion. Int Ophthalmol. 2017;37(1):47–53. doi:10.1007/s10792-016-0226-3
   PubMed Web of Science ®Google Scholar
• Georgalas L, Tservakis I, Kiskira EE, et al. Efficacy and safety of dexamethasone intravitreal implant in patients with retinal vein occlusion resistant to anti-VEGF therapy: a 12-month prospective study. Cutan Ocul Toxicol. 2019;38(4):330–337. doi:10.1080/15569527.2019.1614020
   PubMed Web of Science ®Google Scholar
• Mayer WJ, Remy M, Wolf A, et al. Comparison of intravitreal bevacizumab upload followed by a dexamethasone implant versus dexamethasone implant monotherapy for retinal vein occlusion with macular edema. Ophthalmologica. 2012;228(2):110–116. doi:10.1159/000338732
   PubMed Web of Science ®Google Scholar
• Singer MA, Bell DJ, Woods P, et al. Effect of combination therapy with bevacizumab and dexamethasone intravitreal implant in patients with retinal vein occlusion. Retina. 2012;32(7):1289–1294. doi:10.1097/IAE.0b013e318242b838
   PubMed Web of Science ®Google Scholar
• Maturi RK, Chen V, Raghinaru D, et al. A 6-month, subject-masked, randomized controlled study to assess efficacy of dexamethasone as an adjunct to bevacizumab compared with bevacizumab alone in the treatment of patients with macular edema due to central or branch retinal vein occlusion. Clin Ophthalmol. 2014;810:57–64.
   Google Scholar
• Giuffrè C, Cicinelli MV, Marchese A, et al. Simultaneous intravitreal dexamethasone and aflibercept for refractory macular edema secondary to retinal vein occlusion. Graefes Arch Clin Exp Ophthalmol. 2020;258(4):787–793. doi:10.1007/s00417-019-04577-8
   PubMed Web of Science ®Google Scholar
• Harb W, Chidiac G, Harb G. Outcomes of combination therapy using aflibercept and dexamethasone intravitreal implant versus dexamethasone monotherapy for macular edema secondary to retinal vein occlusion. Middle East Afr J Ophthalmol. 2021;28(1):18–22. doi:10.4103/meajo.MEAJO_297_19
   PubMed Web of Science ®Google Scholar
• Bezatis A, Spital G, Höhn F, et al. Functional and anatomical results after a single intravitreal ozurdex injection in retinal vein occlusion: a 6-month follow-up – the SOLO study. Acta Ophthalmol. 2013;91(5):340. doi:10.1111/aos.12020
   PubMed Web of Science ®Google Scholar
• Korobelnik J, Kodjikian L, Delcourt C, et al. Two-year, prospective, multicenter study of the use of dexamethasone intravitreal implant for treatment of macular edema secondary to retinal vein occlusion in the clinical setting in France. Graefes Arch Clin Exp Ophthalmol. 2016;254(12):2307–2318. doi:10.1007/s00417-016-3394-y
   PubMed Web of Science ®Google Scholar
• Capone A, Singer MA, Dodwell DG, et al. Efficacy and safety of two or more dexamethasone intravitreal implant injections for treatment of macular edema related to retinal vein occlusion (Shasta study). Retina. 2014;34(2):342–351. doi:10.1097/IAE.0b013e318297f842
   PubMed Web of Science ®Google Scholar
• Singer MA, Capone A, Dugel PU, et al. Two or more dexamethasone intravitreal implants as monotherapy or in combination therapy for macular edema in retinal vein occlusion: subgroup analysis of a retrospective chart review study. BMC Ophthalmol. 2015;15(1):118. doi:10.1186/s12886-015-0106-z
   PubMed Web of Science ®Google Scholar
• Eter N, Mohr A, Wachtlin J, et al. Dexamethasone intravitreal implant in retinal vein occlusion: real-life data from a prospective, multicenter clinical trial. Graefes Arch Clin Exp Ophthalmol. 2017;255(1):77–87. doi:10.1007/s00417-016-3431-x
   PubMed Web of Science ®Google Scholar
• Horner F, Lip PL, Mushtaq B, et al. Combination therapy for macular oedema in retinal vein occlusions: 3-year results from a real-world clinical practice. Clin Ophthalmol. 2020;149:55–65.
   Google Scholar
• Kim MS, Choi J, Lee HD, et al. Dexamethasone intravitreal implant for the treatment of macular edema following retinal vein occlusion: post hoc analysis of post-marketing surveillance data in the real-world setting in Korea. Clin Ophthalmol. 2021;153:623–636.
   Google Scholar
• Garay-Aramburu G, Gómez-Moreno Á, Urcola A. Short-term effectiveness prognostic factors after dexamethasone intravitreal implant in macular edema due to retinal vein occlusion. Eur J Ophthalmol. 2021:11206721211032520. doi:10.1177/11206721211032520
   Web of Science ®Google Scholar
• Moisseiev E, Goldstein M, Waisbourd M, et al. Long-term evaluation of patients treated with dexamethasone intravitreal implant for macular edema due to retinal vein occlusion. Eye. 2013;27(1):65–71. doi:10.1038/eye.2012.226
   PubMed Web of Science ®Google Scholar
• Nussenblatt RB. The natural history of uveitis. Int Ophthalmol. 1990;14(5–6):303–308. doi:10.1007/BF00163549
   PubMed Web of Science ®Google Scholar
• Gritz DC, Wong IG. Incidence and prevalence of uveitis in northern California; the northern California epidemiology of uveitis study. Ophthalmology. 2004;111(3):491–500; discussion 500. doi:10.1016/j.ophtha.2003.06.014
   PubMed Web of Science ®Google Scholar
• Suhler EB, Lloyd MJ, Choi D, et al. Incidence and prevalence of uveitis in veterans affairs medical centers of the pacific northwest. Am J Ophthalmol. 2008;146(6):890,896.e8. doi:10.1016/j.ajo.2008.09.014
   Web of Science ®Google Scholar
• Thorne JE, Suhler E, Skup M, et al. Prevalence of noninfectious uveitis in the United States: a claims-based analysis. JAMA Ophthalmol. 2016;134(11):1237–1245. doi:10.1001/jamaophthalmol.2016.3229
   PubMed Web of Science ®Google Scholar
• Acharya NR, Tham VM, Esterberg E, et al. Incidence and prevalence of uveitis: results from the pacific ocular inflammation study. JAMA Ophthalmol. 2013;131(11):1405–1412. doi:10.1001/jamaophthalmol.2013.4237
   PubMed Web of Science ®Google Scholar
• Okhravi N, Lightman S. Cystoid macular edema in uveitis. Ocul Immunol Inflamm. 2003;11(1):29–38. doi:10.1076/ocii.11.1.29.15582
   PubMed Web of Science ®Google Scholar
• Ossewaarde-van Norel A, Rothova A. Clinical review: update on treatment of inflammatory macular edema. Ocul Immunol Inflamm. 2011;19(1):75–83. doi:10.3109/09273948.2010.509530
   PubMed Web of Science ®Google Scholar
• Durrani OM, Tehrani NN, Marr JE, et al. Degree, duration, and causes of visual loss in uveitis. Br J Ophthalmol. 2004;88(9):1159–1162. doi:10.1136/bjo.2003.037226
   PubMed Web of Science ®Google Scholar
• Kempen JH, Altaweel MM, Holbrook JT, et al. The multicenter uveitis steroid treatment trial: rationale, design, and baseline characteristics. Am J Ophthalmol. 2010;149(4):550–561.e10.
   PubMed Web of Science ®Google Scholar
• Grajewski RS, Boelke AC, Adler W, et al. Spectral-domain optical coherence tomography findings of the macula in 500 consecutive patients with uveitis. Eye. 2016;30(11):1415–1423. doi:10.1038/eye.2016.133
   PubMed Web of Science ®Google Scholar
• Dick AD, Rosenbaum JT, Al-Dhibi H, et al. Guidance on noncorticosteroid systemic immunomodulatory therapy in noninfectious uveitis: fundamentals of care for UveitiS (FOCUS) initiative. Ophthalmology. 2018;125(5):757–773. doi:10.1016/j.ophtha.2017.11.017
   PubMed Web of Science ®Google Scholar
• Yasukawa T, Ogura Y, Sakurai E, et al. Intraocular sustained drug delivery using implantable polymeric devices. Adv Drug Deliv Rev. 2005;57(14):2033–2046. doi:10.1016/j.addr.2005.09.005
   PubMed Web of Science ®Google Scholar
• Lowder C, Belfort R, Lightman S, et al. Dexamethasone intravitreal implant for noninfectious intermediate or posterior uveitis. Arch Ophthalmol. 2011;129(5):545–553. doi:10.1001/archophthalmol.2010.339
   PubMed Web of Science ®Google Scholar
• Pelegrín L, de la Maza MS, Molins B, et al. Long-term evaluation of dexamethasone intravitreal implant in vitrectomized and non-vitrectomized eyes with macular edema secondary to non-infectious uveitis. Eye. 2015;29(7):943–950. doi:10.1038/eye.2015.73
   PubMed Web of Science ®Google Scholar
• Tsang AC, Virgili G, Abtahi M, et al. Intravitreal dexamethasone implant for the treatment of macular edema in chronic non-infectious uveitis. Ocul Immunol Inflamm. 2017;25(5):685–692. doi:10.3109/09273948.2016.1160130
   PubMed Web of Science ®Google Scholar
• Nobre-Cardoso J, Champion E, Darugar A, et al. Treatment of non-infectious uveitic macular edema with the intravitreal dexamethasone implant. Ocul Immunol Inflamm. 2017;25(4):447–454. doi:10.3109/09273948.2015.1132738
   PubMed Web of Science ®Google Scholar
• Fabiani C, Vitale A, Emmi G, et al. Systemic steroid sparing effect of intravitreal dexamethasone implant in chronic noninfectious uveitic macular edema. J Ocul Pharmacol Ther. 2017;33(7):549–555. doi:10.1089/jop.2017.0034
   PubMed Web of Science ®Google Scholar
• Ratra D, Barh A, Banerjee M, et al. Safety and efficacy of intravitreal dexamethasone implant for refractory uveitic macular edema in adults and children. Ocul Immunol Inflamm. 2018;26(7):1034–1040. doi:10.1080/09273948.2018.1424342
   PubMed Web of Science ®Google Scholar
• Thorne JE, Sugar EA, Holbrook JT, et al. Periocular triamcinolone vs. intravitreal triamcinolone vs. intravitreal dexamethasone implant for the treatment of uveitic macular edema: the PeriOcular vs. INTravitreal corticosteroids for uveitic macular edema (POINT) trial. Ophthalmology. 2019;126(2):283–295. doi:10.1016/j.ophtha.2018.08.021
   PubMed Web of Science ®Google Scholar
• Miyamoto K, Khosrof S, Bursell SE, et al. Prevention of leukostasis and vascular leakage in streptozotocin-induced diabetic retinopathy via intercellular adhesion molecule-1 inhibition. Proc Natl Acad Sci U S A. 1999;96(19):10836–10841. doi:10.1073/pnas.96.19.10836
   PubMed Web of Science ®Google Scholar
• Ehrlich R, Harris A, Ciulla TA, et al. Diabetic macular oedema: physical, physiological and molecular factors contribute to this pathological process. Acta Ophthalmol. 2010;88(3):279–291. doi:10.1111/j.1755-3768.2008.01501.x
   PubMed Web of Science ®Google Scholar
• Tang J, Kern TS. Inflammation in diabetic retinopathy. Prog Retin Eye Res. 2011;30(5):343–358. doi:10.1016/j.preteyeres.2011.05.002
   PubMed Web of Science ®Google Scholar
• Zur D, Iglicki M, Loewenstein A. The role of steroids in the management of diabetic macular edema. Ophthalmic Res. 2019;62(4):231–236. doi:10.1159/000499540
   PubMed Web of Science ®Google Scholar
• Funatsu H, Noma H, Mimura T, et al. Association of vitreous inflammatory factors with diabetic macular edema. Ophthalmology. 2009;116(1):73–79. doi:10.1016/j.ophtha.2008.09.037
   PubMed Web of Science ®Google Scholar
• Wang K, Wang Y, Gao L, et al. Dexamethasone inhibits leukocyte accumulation and vascular permeability in retina of streptozotocin-induced diabetic rats via reducing vascular endothelial growth factor and intercellular adhesion molecule-1 expression. Biol Pharm Bull. 2008;31(8):1541–1546. doi:10.1248/bpb.31.1541
   PubMed Web of Science ®Google Scholar
• Boyer DS, Yoon YH, Belfort R, et al. Three-year, randomized, sham-controlled trial of dexamethasone intravitreal implant in patients with diabetic macular edema. Ophthalmology. 2014;121(10):1904–1914. doi:10.1016/j.ophtha.2014.04.024
   PubMed Web of Science ®Google Scholar
• Haller JA, Kuppermann BD, Blumenkranz MS, et al. Randomized controlled trial of an intravitreous dexamethasone drug delivery system in patients with diabetic macular edema. Arch Ophthalmol. 2010;128(3):289–296. doi:10.1001/archophthalmol.2010.21
   PubMed Web of Science ®Google Scholar
• Pacella E, Vestri AR, Muscella R, et al. Preliminary results of an intravitreal dexamethasone implant (Ozurdex®) in patients with persistent diabetic macular edema. Clin Ophthalmol. 2013;714:23–28.
   Google Scholar
• Lazic R, Lukic M, Boras I, et al. Treatment of anti-vascular endothelial growth factor-resistant diabetic macular edema with dexamethasone intravitreal implant. Retina. 2014;34(4):719–724. doi:10.1097/IAE.0b013e3182a48958
   PubMed Web of Science ®Google Scholar
• Boyer DS, Faber D, Gupta S, et al. Dexamethasone intravitreal implant for treatment of diabetic macular edema in vitrectomized patients. Retina. 2011;31(5):915–923. doi:10.1097/IAE.0b013e318206d18c
   PubMed Web of Science ®Google Scholar
• Medeiros MD, Alkabes M, Navarro R, et al. Dexamethasone intravitreal implant in vitrectomized versus nonvitrectomized eyes for treatment of patients with persistent diabetic macular edema. J Ocul Pharmacol Ther. 2014;30(9):709–716. doi:10.1089/jop.2014.0010
   PubMed Web of Science ®Google Scholar
• Augustin AJ, Kuppermann BD, Lanzetta P, et al. Dexamethasone intravitreal implant in previously treated patients with diabetic macular edema: subgroup analysis of the MEAD study. BMC Ophthalmol. 2015;15:150.
   PubMed Web of Science ®Google Scholar
• Castro-Navarro V, Cervera-Taulet E, Navarro-Palop C, et al. Intravitreal dexamethasone implant Ozurdex® in naïve and refractory patients with different subtypes of diabetic macular edema. BMC Ophthalmol. 2019;19(1):15. doi:10.1186/s12886-018-1022-9
   PubMed Web of Science ®Google Scholar
• Chhablani J, Bansal P, Veritti D, et al. Dexamethasone implant in diabetic macular edema in real-life situations. Eye. 2016;30(3):426–430. doi:10.1038/eye.2015.246
   PubMed Web of Science ®Google Scholar
• Mastropasqua R, Toto L, Borrelli E, et al. Morphology and function over a one-year follow up period after intravitreal dexamethasone implant (ozurdex) in patients with diabetic macular edema. PLoS One. 2015;10(12):e0145663. doi:10.1371/journal.pone.0145663
   PubMed Web of Science ®Google Scholar
• Mathew R, Pearce E, Muniraju R, et al. Monthly OCT monitoring of ozurdex for macular oedema related to retinal vascular diseases: re-treatment strategy (OCTOME report 1). Eye. 2014;28(3):318–326. doi:10.1038/eye.2013.287
   PubMed Web of Science ®Google Scholar
• Callanan DG, Gupta S, Boyer DS, et al. Dexamethasone intravitreal implant in combination with laser photocoagulation for the treatment of diffuse diabetic macular edema. Ophthalmology. 2013;120(9):1843–1851. doi:10.1016/j.ophtha.2013.02.018
   PubMed Web of Science ®Google Scholar
• Callanan DG, Loewenstein A, Patel SS, et al. A multicenter, 12-month randomized study comparing dexamethasone intravitreal implant with ranibizumab in patients with diabetic macular edema. Graefes Arch Clin Exp Ophthalmol. 2017;255(3):463–473. doi:10.1007/s00417-016-3472-1
   PubMed Web of Science ®Google Scholar
• Yuan Q, Liu Y, Xu H, et al. Efficacy and safety of single-dose dexamethasone implantation for patients with persistent diabetic macular edema: a systematic review and meta-analysis. Graefes Arch Clin Exp Ophthalmol. 2021;260(2):405–413. doi:10.1007/s00417-021-05369-9
   PubMed Web of Science ®Google Scholar
• He Y, Ren X, Hu B, et al. A meta-analysis of the effect of a dexamethasone intravitreal implant versus intravitreal anti-vascular endothelial growth factor treatment for diabetic macular edema. BMC Ophthalmol. 2018;18(1):121. doi:10.1186/s12886-018-0779-1
   PubMed Web of Science ®Google Scholar
• Maturi RK, Bleau L, Saunders J, et al. A 12-month, single-masked, randomized controlled study of eyes with persistent diabetic macular edema after multiple anti-VEGF injections to assess the efficacy of the dexamethasone-delayed delivery system as an adjunct to bevacizumab compared with continued bevacizumab monotherapy. Retina. 2015;35(8):1604–1614. doi:10.1097/IAE.0000000000000533
   PubMed Web of Science ®Google Scholar
• Mehta H, Hennings C, Gillies MC, et al. Anti-vascular endothelial growth factor combined with intravitreal steroids for diabetic macular oedema. Cochrane Database Syst Rev. 2018;4:CD011599.
   PubMedGoogle Scholar
• Maturi RK, Glassman AR, Liu D, et al. Effect of adding dexamethasone to continued ranibizumab treatment in patients with persistent diabetic macular edema: a DRCR network phase 2 randomized clinical trial. JAMA Ophthalmol. 2018;136(1):29–38. doi:10.1001/jamaophthalmol.2017.4914
   PubMed Web of Science ®Google Scholar
• Rittiphairoj T, Mir TA, Li T, et al. Intravitreal steroids for macular edema in diabetes. Cochrane Database Syst Rev. 2020;11:CD005656.
   PubMedGoogle Scholar
• Medeiros DM, Postorino M, Navarro R, et al. Dexamethasone intravitreal implant for treatment of patients with persistent diabetic macular edema. Ophthalmologica. 2014;231(3):141–146. doi:10.1159/000356413
   PubMed Web of Science ®Google Scholar
• Totan Y, Güler E, Gürağaç FB. Dexamethasone intravitreal implant for chronic diabetic macular edema resistant to intravitreal bevacizumab treatment. Curr Eye Res. 2016;41(1):107–113. doi:10.3109/02713683.2014.1002048
   PubMed Web of Science ®Google Scholar
• Shah SU, Harless A, Bleau L, et al. Prospective randomized subject-masked study of intravitreal bevacizumab monotherapy versus dexamethasone implant monotherapy in the treatment of persistent diabetic macular edema. Retina. 2016;36(10):1986–1996. doi:10.1097/IAE.0000000000001038
   PubMed Web of Science ®Google Scholar
• Downey L, Acharya N, Devonport H, et al. Treatment choices for diabetic macular oedema: a guideline for when to consider an intravitreal corticosteroid, including adaptations for the COVID-19 era. BMJ Open Ophthalmol. 2021;6(1):e000696. doi:10.1136/bmjophth-2020-000696
   PubMed Web of Science ®Google Scholar
• Calvo P, Ferreras A, Al Adel F, et al. Dexamethasone intravitreal implant as adjunct therapy for patients with wet age-related macular degeneration with incomplete response to ranibizumab. Br J Ophthalmol. 2015;99(6):723–726. doi:10.1136/bjophthalmol-2014-305684
   PubMed Web of Science ®Google Scholar
• Barikian A, Salti H, Safar A, et al. Intravitreal dexamethasone implant as adjuvant treatment for bevacizumab- and ranibizumab-resistant neovascular age-related macular degeneration: a prospective pilot study. Retina. 2017;37(7):1337–1344. doi:10.1097/IAE.0000000000001366
   PubMed Web of Science ®Google Scholar
• Giancipoli E, Pinna A, Boscia F, et al. Intravitreal dexamethasone in patients with wet age-related macular degeneration resistant to anti-VEGF: a prospective pilot study. J Ophthalmol. 2018;2018:5612342.
   PubMed Web of Science ®Google Scholar
• Rezar-Dreindl S, Eibenberger K, Buehl W, et al. Role of additional dexamethasone for the management of persistent or recurrent neovascular age-related macular degeneration under ranibizumab treatment. Retina. 2017;37(5):962–970. doi:10.1097/IAE.0000000000001264
   PubMed Web of Science ®Google Scholar
• Chaudhary V, Barbosa J, Lam W, et al. Ozurdex in age-related macular degeneration as adjunct to ranibizumab (the OARA study). Can J Ophthalmol. 2016;51(4):302–305. doi:10.1016/j.jcjo.2016.04.020
   PubMed Web of Science ®Google Scholar
• Mallikarjun K, Narayanan R, Raman R, et al. Dexamethasone implant improves anatomic response to anti-VEGF therapy in treatment-resistant polypoidal choroidal vasculopathy. Int Ophthalmol. 2021. doi:10.1007/s10792-021-02113-4
   Web of Science ®Google Scholar
• Ahn SJ, Kim KE, Woo SJ, et al. The effect of an intravitreal dexamethasone implant for cystoid macular edema in retinitis pigmentosa: a case report and literature review. Ophthalmic Surg Lasers Imaging Retina. 2014;45(2):160–164. doi:10.3928/23258160-20140131-03
   PubMed Web of Science ®Google Scholar
• Sudhalkar A, Kodjikian L, Borse N. Intravitreal dexamethasone implant for recalcitrant cystoid macular edema secondary to retinitis pigmentosa: a pilot study. Graefes Arch Clin Exp Ophthalmol. 2017;255(7):1369–1374. doi:10.1007/s00417-017-3660-7
   PubMed Web of Science ®Google Scholar
• Park UC, Park JH, Ma DJ, et al. A randomized paired-eye trial of intravitreal dexamethasone implant for cystoid macular edema in retinitis pigmentosa. Retina. 2020;40(7):1359–1366. doi:10.1097/IAE.0000000000002589
   PubMed Web of Science ®Google Scholar
• Veritti D, Sarao V, De Nadai K, et al. Dexamethasone implant produces better outcomes than oral Acetazolamide in patients with cystoid macular edema secondary to retinitis pigmentosa. J Ocul Pharmacol Ther. 2020;36(3):190–197. doi:10.1089/jop.2018.0153
   PubMed Web of Science ®Google Scholar
• Ahn SJ, Joung J, Lee SH, et al. Intravitreal dexamethasone implant therapy for the treatment of cystoid macular oedema due to hydroxychloroquine retinopathy: a case report and literature review. BMC Ophthalmol. 2018;18(1):310. doi:10.1186/s12886-018-0985-x
   PubMed Web of Science ®Google Scholar
• Hattenbach L, Kuhli-Hattenbach C, Springer C, et al. [Intravitreal dexamethasone implant for treatment of persistent postoperative macular edema after vitrectomy]. Ophthalmologe. 2016;113(7):581–588. German. doi:10.1007/s00347-016-0223-y
   PubMed Web of Science ®Google Scholar
• Bonfiglio V, Reibaldi M, Fallico M, et al. Widening use of dexamethasone implant for the treatment of macular edema. Drug Des Devel Ther. 2017;112:359–372.
   Google Scholar
• Banerjee PJ, Bunce C, Charteris DG. Ozurdex (a slow-release dexamethasone implant) in proliferative vitreoretinopathy: study protocol for a randomised controlled trial. Trials. 2013;14:358.
   PubMed Web of Science ®Google Scholar
• Bennedjai A, Theillac V, Akesbi J, et al. The effect of selective laser trabeculoplasty on intraocular pressure in patients with dexamethasone intravitreal implant-induced elevated intraocular pressure. J Ophthalmol. 2020;2020:3439182.
   PubMed Web of Science ®Google Scholar
• Chaudhry SG, Fung AT. Cytomegalovirus retinitis following dexamethasone intravitreal implant. Am J Ophthalmol Case Rep. 2021;22:101055.
   PubMedGoogle Scholar
• Witmer MT, Connolly BP. Cytomegalovirus retinitis after an intravitreal dexamethasone implant in an immunocompetent patient. Retin Cases Brief Rep. 2021;15(6):670–672. doi:10.1097/ICB.0000000000000904
   PubMedGoogle Scholar
• Vannozzi L, Bacherini D, Sodi A, et al. Cytomegalovirus retinitis following intravitreal dexamethasone implant in a patient with central retinal vein occlusion. Acta Ophthalmol. 2016;94(2):158. doi:10.1111/aos.12783
   Web of Science ®Google Scholar
• Dogra M, Rohilla V, Dogra M, et al. Macular cytomegalovirus retinitis following dexamethasone intravitreal implant combined with phacoemulsification. Indian J Ophthalmol. 2018;66(9):1361–1363. doi:10.4103/ijo.IJO_171_18
   PubMed Web of Science ®Google Scholar
• Olson DJ, Parhiz AT, Wirthlin RS. Reactivation of latent toxoplasmosis following dexamethasone implant injection. Ophthalmic Surg Lasers Imaging Retina. 2016;47(11):1050–1052. doi:10.3928/23258160-20161031-10
   PubMed Web of Science ®Google Scholar
• Celik N, Khoramnia R, Auffarth GU, et al. Complications of dexamethasone implants: risk factors, prevention, and clinical management. Int J Ophthalmol. 2020;13(10):1612–1620. doi:10.18240/ijo.2020.10.16
   PubMed Web of Science ®Google Scholar
• Casati S, Bruni E, Marchini G. Retinal and vitreous hemorrhage after traumatic impact of dexamethasone implant in a vitrectomized eye. Eur J Ophthalmol. 2016;26(3):55. doi:10.5301/ejo.5000716
   Web of Science ®Google Scholar
• Stelton CR, Townsend J, Peterson LT, et al. Surgical management of anterior chamber migration of a dexamethasone intravitreal implant. Ophthalmic Surg Lasers Imaging Retina. 2015;46(7):756–759. doi:10.3928/23258160-20150730-11
   PubMed Web of Science ®Google Scholar
• Khurana RN, Appa SN, McCannel CA, et al. Dexamethasone implant anterior chamber migration: risk factors, complications, and management strategies. Ophthalmology. 2014;121(1):67–71. doi:10.1016/j.ophtha.2013.06.033
   PubMed Web of Science ®Google Scholar
• Röck D, Bartz-Schmidt KU, Röck T. Risk factors for and management of anterior chamber intravitreal dexamethasone implant migration. BMC Ophthalmol. 2019;19(1):120. doi:10.1186/s12886-019-1122-1
   PubMed Web of Science ®Google Scholar
• Clemente-Tomás R, Hernández-Pérez D, Neira-Ibáñez P, et al. Intracrystalline Ozurdex®: therapeutic effect maintained for 18 months. Int Ophthalmol. 2019;39(1):207–211. doi:10.1007/s10792-017-0780-3
   PubMed Web of Science ®Google Scholar
• Kurt A, Durukan AH, Küçükevcilioğlu M. Accidental intralenticular injection of Ozurdex® for branch retinal vein occlusion: intact posterior capsule and resolution of macular edema. Case Rep Ophthalmol Med. 2019;2019:8630504.
   PubMed Web of Science ®Google Scholar
• Fasce F, Battaglia Parodi M, Knutsson KA, et al. Accidental injection of dexamethasone intravitreal implant in the crystalline lens. Acta Ophthalmol. 2014;92(4):330. doi:10.1111/aos.12332
   PubMed Web of Science ®Google Scholar
• De Benedetto U, Battaglia Parodi M, Knutsson KA, et al. Macular hole after injection of dexamethasone intravitreal implant for macular oedema due to central retinal vein occlusion. Acta Ophthalmol. 2013;91(1):75. doi:10.1111/j.1755-3768.2012.02484.x
   Web of Science ®Google Scholar
• Ekinci C, Kayıran A, Özdemir H. Extramacular retinal hole following intravitreal dexamethasone implant: case report. Turk J Ophthalmol. 2019;49(3):175–177. doi:10.4274/tjo.galenos.2019.98975
   PubMedGoogle Scholar