Purpose: To describe in vivo longitudinal modifcatons of the Ozurdex intravitreal implant using spectral-domain optcal coherence tomography (SD-OCT) over a 6-month period in an eye treated for retnal vein occlusion (RVO). Methods: Case report. Results: An 82-year-old woman with severe macular edema secondary to branch RVO received an Ozurdex in-travitreal implant in the lef eye. At day 1, SD-OCT showed that the implant was completely flled with highly refectve dexamethasone. At day 30, complete resoluton of macular edema on SD-OCT was noted. At day 60, macular edema started to relapse; SD-OCT scans over the implant showed highly refectve borders that appeared irregular and focally retracted, while the majority of the internal drug had been washed out. At day 180, macular edema returned to baseline levels; SD-OCT scans over the implant showed that the device was contracted with almost complete absence of the internal lumen and drug. Conclusions: Using SD-OCT, we demonstrated that 60 days postnjecton most dexamethasone had been released from the Ozurdex implant, which showed multple irregularites. This was associated with recurrence of macular edema that became worse afer 180 days, when there was no residual dexamethasone remaining in the shrunken implant. Low steady levels of the drug in the vitreous and lower biological actvity in the retna afer the 2-month high-dose release phase may explain why a large number of patents lose clinical improvement 60 days postnjec-ton, as shown by pivotal clinical trials.
- Intravitreal dexamethasone
- Intravitreal implant
- Macular edema
- Spectral-domain optcal coherence tomography
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