EFFECTS OF DEXAMETHASONE IMPLANT ON CONTRALATERAL CENTRAL FOVEAL AND SUBFOVEAL CHOROIDAL THICKNESS IN UNILATERAL UVEITIC MACULAR EDEMA
Effects of Intravitreal Dexamethasone Implant on Contralateral Eye
Keywords:
choroidal thickness, dexamethasone implant, uveitic macular edemaAbstract
Objectives: To investigate the effect of Ozurdex® application on retinal and choroidal thickness of contralateral eye of the patients with uveitic macular edema.
Materials and Methods: This study included 17 patients with uveitic macular edema treated with Ozurdex® implantation. The central foveal thickness (CFT) and subfoveal choroidal thickness (SFCT) measurement taken by swept-source optic coherence tomography were evaluated retrospectively at the pre- and post-injection 1st, 3rd, 6th months, and its relationship with visual acuity was investigated.
Results: Four (23.57%) of the patients had intermediate, 3 (17.64%) had anterior and 10 (58.82%) of them had panuveitis. The mean CFT and SFCT of the eyes with intravitreal implants were 494.3±171.1 and 346.1±68.8 µm respectively. There was a statistically significant decrease of CFT and SFCT from the baseline in the 1st month (318.1±65.0 and 203.9±62.1µm), 3rd month (314.2±74.2 and 222.1±61.6µm) and 6th month (320.6±77.1 and 224.3±72.6µm) after the injection (p<0.05). The mean CFT of contralateral eyes was 205.8±55.0µm before injection and did not change significantly post-injection. The mean SFCT of the contralateral eyes before the injection was 311.2±72.9µm. Decrease in SFCT of the contralateral eyes at 1st month (288.6±68.5 µm) (p=0.02) was statistically significant. No significant change was observed in visual acuity after injection in contralateral eyes.
Conclusion: Decrease in the choroidal thickness of the contralateral eyes of patients was so limited and temporary that they did not reflect on their visual acuity. Therefore, it was thought that this may be secondary to the small amount of systemic absorption of intravitreal dexamethasone.
References
Sood G, Patel BC. Uveitic Macular Edema. In: StatPearls. Treasure Island (FL): StatPearls Publishing; May 24, 2022.
Rothova A, Suttorp-van Schulten MS, Frits Treffers W, Kijlstra A. Causes and frequency of blindness in patients with intraocular inflammatory disease. Br J Ophthalmol. 1996;80(4):332-336.
Lowder C, Belfort R, Lightman S, et al. Dexamethasone intravitreal implant for noninfectious intermediate or posterior uveitis. Arch Ophthalmol. 2011;129(5):54510.
Campos A, Campos EJ, Martins J, et al.. Viewing the choroid: where we stand, challenges and contradictions in diabetic retinopathy and diabetic macular oedema. Acta Ophthalmol 2017;95:446–459.
Zur D, Iglicki M, Busch C, et al.. OCT biomarkers as functional outcome predictors in diabetic macular edema treated with dexamethasone implant. Ophthalmology 2018;125:267–275.
Habot-Wilner Z, Sorkin N, Goldenberg D, Goldstein M. Bilateral effect of unilateral dexamethasone intravitreal implant in a case of noninfectious uveitic macular edema and vitritis. Retin Cases Brief Rep. 2015;9(2):151–153.
Chang-Lin JE, Attar M, Acheampong AA, et al. Pharmacokinetics and pharmacodynamics of a sustained-release dexamethasone intravitreal implant. Invest Ophthalmol Vis Sci 2011;52:80–86.
Fleissig E, Sigford DK. Effect of Extended Release Steroid Implants on the Contralateral Eye. BMC Ophthalmol. 2022;22(1):131. Published 2022 Mar 22.
Klaassen I, Van Noorden CJ, Schlingemann RO. Molecular basis of the inner blood-retinal barrier and its breakdown in diabetic macular edema and other pathological conditions. Prog Retin Eye Res. 2013;34:19–48.
Chahal PS, Fallon TJ, Kohner EM. Measurement of Blood-Retinal Barrier Function in Central Retinal Vein Occlusion. Arch Ophthalmol. 1986;104(4):554–7.
Gulati SK, Pillai GS, Radhakrishnan N. Effect of intravitreal dexamethasone implant on the contralateral eye in recalcitrant radiation maculopathy. Oman J Ophthalmol. 2019;12(2):129-132.
Thomas BJ, Yonekawa Y, Wolfe JD, Hassan TS. Contralateral eye-to-eye comparison of intravitreal ranibizumab and a sustained-release dexamethasone intravitreal implant in recalcitrant diabetic macular edema. Clin Ophthalmol. 2016;10:1679-1684. Published 20.
Downloads
Published
Issue
Section
License
Copyright (c) 2025 The THAI Journal of OPHTHALMOLOGY
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
The Thai Journal of Ophthalmology (TJO) is a peer-reviewed, scientific journal published biannually for the Royal College of Ophthalmologists of Thailand. The objectives of the journal is to provide up to date scientific knowledge in the field of ophthalmology, provide ophthalmologists with continuing education, promote cooperation, and sharing of opinion among readers.
The copyright of the published article belongs to the Thai Journal of Ophthalmology. However the content, ideas and the opinions in the article are from the author(s). The editorial board does not have to agree with the authors’ ideas and opinions.
The authors or readers may contact the editorial board via email at admin@rcopt.org.
