Long term efficacy and safety profile of dexamethasone intravitreal implant in retinal vein occlusions: a systematic review
Background/objectiveRetinal vein occlusion (RVO) is a common, sight-threatening vascular disorder affecting individuals of all ages, with incidence increasing with age. Due to its complex, multifactorial nature, treating RVO remains a clinical challenge. Currently, treatment strategies include laser...
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Frontiers Media S.A.
2024-11-01
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fmed.2024.1454591/full |
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| author | Adriano Carnevali Daniela Bacherini Cristian Metrangolo Flavia Chiosi Pasquale Viggiano Carlo Astarita Valentina Gallinaro Vincenza M. E. Bonfiglio |
| author_facet | Adriano Carnevali Daniela Bacherini Cristian Metrangolo Flavia Chiosi Pasquale Viggiano Carlo Astarita Valentina Gallinaro Vincenza M. E. Bonfiglio |
| author_sort | Adriano Carnevali |
| collection | DOAJ |
| description | Background/objectiveRetinal vein occlusion (RVO) is a common, sight-threatening vascular disorder affecting individuals of all ages, with incidence increasing with age. Due to its complex, multifactorial nature, treating RVO remains a clinical challenge. Currently, treatment strategies include laser photocoagulation (especially for branch RVO), anti-VEGF therapies, and intravitreal corticosteroids. This systematic review (without meta-analysis) aimed to update the evidence on the efficacy and safety of the sustained-release intravitreal dexamethasone implant (DEX-i) in managing macular edema (ME) secondary to central and branch RVO.MethodsA systematic review was conducted to assess current literature on DEX-i for ME secondary to RVO. Relevant studies were analyzed for outcomes related to visual acuity, retinal thickness, and the safety profile of DEX-i in RVO treatment.ResultsEvidence indicates that DEX-i substantially improves best-corrected visual acuity (BCVA) and reduces central retinal thickness (CRT) in ME associated with both branch and central RVO, demonstrating rapid and sustained effects. Common adverse events associated with DEX-i included manageable complications, such as medically controlled intraocular pressure elevation and progression of cataracts.ConclusionDEX-i offers effective and sustained improvements in both visual and anatomical outcomes for patients with ME secondary to RVO. Individualized treatment selection is essential to optimize patient outcomes. Future directions include identifying predictive biomarkers and adopting patient-centered approaches based on individual clinical characteristics, which may enhance treatment success in RVO. |
| format | Article |
| id | doaj-art-952d6bf983a64678ac033bc57eb41da3 |
| institution | OA Journals |
| issn | 2296-858X |
| language | English |
| publishDate | 2024-11-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Medicine |
| spelling | doaj-art-952d6bf983a64678ac033bc57eb41da32025-08-20T01:54:30ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2024-11-011110.3389/fmed.2024.14545911454591Long term efficacy and safety profile of dexamethasone intravitreal implant in retinal vein occlusions: a systematic reviewAdriano Carnevali0Daniela Bacherini1Cristian Metrangolo2Flavia Chiosi3Pasquale Viggiano4Carlo Astarita5Valentina Gallinaro6Vincenza M. E. Bonfiglio7Department of Surgical and Medical Sciences, University Magna Graecia of Catanzaro, Catanzaro, ItalyDepartment of Neurosciences, Psychology, Drug Research and Child Health (NEUROFARBA), University of Florence, Florence, ItalySC Oculistica, Ospedale di Circolo e Fondazione Macchi, Varese, ItalyDepartment of Ophthalmology, AORN dei Colli, Monaldi Hospital, Naples, ItalyMedical Retina and Imaging Unit, Department of Translational Biomedicine Neuroscience, University of Bari “Aldo Moro”, Bari, ItalyAbbVie S.r.l., Rome, ItalyAbbVie S.r.l., Rome, ItalyDepartment of Biomedicine, Neuroscience and Advanced Diagnostic, Eye Clinic, University of Palermo, Palermo, ItalyBackground/objectiveRetinal vein occlusion (RVO) is a common, sight-threatening vascular disorder affecting individuals of all ages, with incidence increasing with age. Due to its complex, multifactorial nature, treating RVO remains a clinical challenge. Currently, treatment strategies include laser photocoagulation (especially for branch RVO), anti-VEGF therapies, and intravitreal corticosteroids. This systematic review (without meta-analysis) aimed to update the evidence on the efficacy and safety of the sustained-release intravitreal dexamethasone implant (DEX-i) in managing macular edema (ME) secondary to central and branch RVO.MethodsA systematic review was conducted to assess current literature on DEX-i for ME secondary to RVO. Relevant studies were analyzed for outcomes related to visual acuity, retinal thickness, and the safety profile of DEX-i in RVO treatment.ResultsEvidence indicates that DEX-i substantially improves best-corrected visual acuity (BCVA) and reduces central retinal thickness (CRT) in ME associated with both branch and central RVO, demonstrating rapid and sustained effects. Common adverse events associated with DEX-i included manageable complications, such as medically controlled intraocular pressure elevation and progression of cataracts.ConclusionDEX-i offers effective and sustained improvements in both visual and anatomical outcomes for patients with ME secondary to RVO. Individualized treatment selection is essential to optimize patient outcomes. Future directions include identifying predictive biomarkers and adopting patient-centered approaches based on individual clinical characteristics, which may enhance treatment success in RVO.https://www.frontiersin.org/articles/10.3389/fmed.2024.1454591/fullretinal vein occlusionbranch retinal vein occlusioncentral retinal vein occlusiondexamethasone intravitreal implantmacular edema |
| spellingShingle | Adriano Carnevali Daniela Bacherini Cristian Metrangolo Flavia Chiosi Pasquale Viggiano Carlo Astarita Valentina Gallinaro Vincenza M. E. Bonfiglio Long term efficacy and safety profile of dexamethasone intravitreal implant in retinal vein occlusions: a systematic review Frontiers in Medicine retinal vein occlusion branch retinal vein occlusion central retinal vein occlusion dexamethasone intravitreal implant macular edema |
| title | Long term efficacy and safety profile of dexamethasone intravitreal implant in retinal vein occlusions: a systematic review |
| title_full | Long term efficacy and safety profile of dexamethasone intravitreal implant in retinal vein occlusions: a systematic review |
| title_fullStr | Long term efficacy and safety profile of dexamethasone intravitreal implant in retinal vein occlusions: a systematic review |
| title_full_unstemmed | Long term efficacy and safety profile of dexamethasone intravitreal implant in retinal vein occlusions: a systematic review |
| title_short | Long term efficacy and safety profile of dexamethasone intravitreal implant in retinal vein occlusions: a systematic review |
| title_sort | long term efficacy and safety profile of dexamethasone intravitreal implant in retinal vein occlusions a systematic review |
| topic | retinal vein occlusion branch retinal vein occlusion central retinal vein occlusion dexamethasone intravitreal implant macular edema |
| url | https://www.frontiersin.org/articles/10.3389/fmed.2024.1454591/full |
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