Authors' recommendations: Macular edema is the main cause of vision loss in patients with retinal vein occlusion (RVO). Without established treatments to reopen occluded retinal veins, current treatment is focused on addressing secondary complications of RVO, such as macular edema. Corticosteroids suppress inflammation, reduce leukostasis, support the barrier function of retinal endothelial cells, and regulate proteins associated with transport of water out of the cell, thereby reducing edema. However, corticosteroids are associated with the formation of cataracts and an increase in intraocular pressure. In addition, while dexamethasone (DEX) is more potent than other corticosteroids (e.g., triamcinolone acetonide), it has a short intravitreal half-life, complicating its use as a clinical therapy. The limitations of steroids for treatment of macular edema secondary to RVO have led to the development of long-acting, sustained-release, intravitreal implants that provide continuous delivery of a low dose of steroids without need for repeated intravitreal injections. Description of Technology: Ozurdex (DEX intravitreal implant; Allergan Inc.) is a sterile, biodegradable, rod-shaped, intravitreal implant containing 0.7 milligrams of the corticosteroid DEX embedded in a NOVADUR solid polymer drug delivery system. The implant is injected into the vitreous cavity of the eye with a single-use, sterile, preloaded 22-gauge applicator. As the implant biodegrades, Ozurdex produces a sustained release of DEX over a period of 6 months or more. The implant remains vitreous up to 270 days before completely dissolving. Patient Population: The DEX implant is indicated for the treatment of adults with macular edema following branch or central RVO, diabetic macular edema, or uveitis. Clinical Alternatives: Clinical alternatives include intravitreal injection of triamcinolone or anti-vascular endothelial growth factor agents (i.e., ranibizumab or bevacizumab) and photocoagulation (laser therapy). Other intravitreal implants include fluocinolone acetonide-containing implants approved for the treatment of diabetic macular edema (Iluvien; Alimera Sciences) and the off-label use of an implant containing 0.59 mg of fluocinolone acetonide (Retisert; Bausch & Lomb) approved by the Food and Drug Administration for uveitis.

Project Status: Completed

Year Published: 2017

URL for published report: The report may be purchased from:http://www.hayesinc.com/hayes/crd/?crd=61326

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: United States

Organisation Name: HAYES, Inc.

Contact Address: 157 S. Broad Street, Suite 200, Lansdale, PA 19446, USA. Tel: 215 855 0615; Fax: 215 855 5218

Contact Name: saleinfo@hayesinc.com

Contact Email: saleinfo@hayesinc.com

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