Intraocular (intravitreal) implant applications or treatment with dexamethasone intravitreal implant, resulted in statistically and clinically significant improvements in both vision and vascular leakage in diabetic macular edema in difficult-to-treat vitrectomized eyes. Intraocular (intravitreal) implant applications has an acceptable safety profile.
Dexamethasone intravitreal implant (Ozurdex, Allergan) or intraocular (intravitreal) implant applications are approved for the treatment of diabetic macular edema (DME), macular edema associated with retinal vein occlusion (RVO), and non-infectious posterior uveitis. While the drug is released at a sustained and safe dose over several months, it delivers a potent corticosteroid through a biodegradable polymer that slowly decomposes into water and carbon dioxide.
Corticosteroids, the down-regulation of inflammatory cytokines, including down regulation of endothelial adhesion molecules and growth factors such as VEGF and has a wide spectrum of biological effects of this drug class, respectively, anti-inflammatory, anti-vascular permeability and gives antianjiyogenik effects. These molecular mechanisms are disordered to varying degrees in many vitreoretinal diseases.
What is Ozurdex?
Ozurdex is an implant that is injected into the eye. It consists of an anti-inflammatory steroid drug called dexamethasone. It is contained in a long-acting implant and a specially designed applicator. The implant is injected directly into the eye. The drug is released slowly inside. It is used to treat adults with visual impairment due to macular edema associated with:
- Blockage of blood vessels that carry blood from the back of the eye
- Damage to blood vessels caused by diabetes in patients with artificial lenses in the eye or when other treatments do not work or are not suitable
Macular edema is swelling of the macula, the middle part of the retina, that is, the light-sensing layer behind the eye, and this can reduce the central part of a person's vision and affect actions such as reading and driving. Ozurdex is also used to treat adults with non-infectious uveitis of the back of the eye. Inflammation of the uvea, the middle layer of the eye, is called uveitis.
Ozurdex can be taken only by prescription and should be given by an ophthalmologist experienced in intravitreal injections (injections of vitreous humor, jelly-like fluid in the eye). Each implant is in an applicator and contains 700 micrograms of the active substance dexamethasone.
Patients are injected one Ozurdex implant at a time directly into the vitreous fluid. If the patient's condition improves but then worsens and if the doctor believes that the patient will benefit from further treatment, further treatments may be given. Implants should no longer be applied to patients whose vision has improved and who remain better. Patients whose vision worsens and is not improved by Ozurdex should also no longer have implants applied.
What are Intraocular (intravitreal) Implant Applications?
Intraocular (intravitreal) implant applications and the clinical application of dexamethasone intravitreal implant is wide, and many studies have reported uses beyond FDA-approved indications. Its effectiveness has been proven in the treatment of macular edema after cataract surgery, retinal detachment repair, epiretinal membrane peeling, radiation maculopathy, retinitis pigmentosa and its use in combination with anti VEGF. Ozurdex is indicated in conditions such as retinal vein occlusion and diabetes mellitus. Dexamethasone is a well-known anti-inflammatory drug.
Which Department Deals with the Intraocular (intravitreal) Implant Applications?
Intraocular (intravitreal) implant applications or dexamethasone intravitreal implant is an effective steroid administration system that provides continuous release of a safe and powerful steroid in a controlled and predictable manner. Retinovascular disorders and posterior uveitis applications have played an important role in the treatment paradigms. Eye surgery deals with intraocular (intravitreal) implant applications.
How are Intraocular (intravitreal) Implant Applications Performed?
Diabetic macular edema (DME) can be treated with different alternatives, among them the dexamethasone intravitreal implant 0.7 mg (DEX 0.7) has shown to improve both central macular thickness (CMT) and best corrected visual acuity (BCVA). This study aimed to evaluate the effect of the intravitreal dexamethasone implant Ozurdex in patients with different subtypes of diabetic macular edema over a 6-month follow-up period.
Ozurdex is given to the patient's eye by a healthcare professional in a clinical setting. The doctor uses a drug to numb the eye before giving an injection. After the administration of this medication, the patient is closely monitored for any swelling, inflammation, or increased pressure in the eye. It is more likely that it is better to see with Ozurdex treatment than to do nothing.
Although injecting the Ozurdex implant is a more complicated procedure than typical small-diameter intravitreal injections, it is the responsibility of retinal specialists who routinely create sclerotomies for non-sutured vitrectomies. The procedure is performed using a sterile technique in a clinical setting. The patient is discharged on the same day the implant is applied.
Intraocular (intravitreal) Implant Applications
Ozurdex implants contain dexamethasone, a corticosteroid used to treat inflammation in intraocular (intravitreal) implant applications. Intraocular dexamethasone is injected into the eye. Ozurdex is a melting implant that is injected into the eye by a healthcare professional to treat swelling that can occur when there is blockage in certain blood vessels in the eyes. Ozurdex is also used to treat posterior uveitis, that is, inflammation that affects the back of the eye.
It can not be treated with Ozurdex if the patient has an allergy to dexamethasone or in the following cases:
- An infection in or around the eye
- An eye ulcer that tears or injures the lens of the eye
- History of surgery or trauma
What are the Advantages of Intraocular (intravitreal) Implant Applications?
Dexamethasone intravitreal implant and two fluocinolone acetonide implants are all continuous-release devices, but their duration of action is different. Fluocinolone implants are designed to last for 3 years. Significantly fewer injections are required, but after the implant is inserted, the eye is potentially devoted to 3 years of steroid exposure and the accompanying IOP complications.
On the other hand, dexamethasone intravitreal implant or intraocular (intravitreal) implant applications, although initially designed to last 6 months, usually provide clinically significant effects for 3 to 4 months based on the experience of persistent edema. The disadvantage of requiring more injections becomes an advantage when managing IOP problems, because steroid effects subside more quickly.
In clinical trials, 20% to 30% of patients with severe retinal disorders experienced an improvement in visual acuity, which was best corrected by the onset of the effect in the first 2 months after treatment. The safety profile of this implant is positive according to clinical data.
The Process After Intraocular (intravitreal) Drug Administration
Ozurdex (dexamethasone) intravitreal implant is a steroid that is injected into the eye to treat swelling that can occur when there is blockage in certain blood vessels in the eyes. Ozurdex is also used to treat non-infectious uveitis affecting the posterior segment of the eye. Common side effects of Ozurdex include:
- Blurred vision
- Inflammation of the eye
- Increased eye pressure
- Retinal detachments
A doctor should be consulted if Ozurdex has any serious side effects, including the following.
- Eye pain
- Seeing halos around lights
- Eye redness
- Increased sensitivity to light in the eyes
- Changes in vision
Ozurdex, can worsen or reactivate an eye infection that has already been owned or recently been passed on. This also includes herpes infection of the eyes. The drug is released slowly in the eye for up to six tues. It is used to improve vision or prevent its worsening. This can be repeated every three years or every six months. About 4 out of 5 patients need a repeat of Ozurdex.