Targeting vascular leakage
Dr. de Smet discussed two cases to highlight a potential role of the sustained-release corticosteroid for managing patients with decreased vision associated with the presence of intraretinal fluid in the absence of any neovascular membrane in the subretinal space.
One patient was a 72-year-old male who had received 17 injections of an anti-VEGF agent. He was next treated with half fluence PDT, but had persistent intraretinal fluid after two sessions given at an interval of four months.
The edema resolved over time and was accompanied by improvement in vision following intravitreal placement of the dexamethasone implant. The benefit persisted for seven months, and the patient responded to retreatment with the dexamethasone implant.
The second patient, a 66-year-old woman, had received 25 anti-VEGF injections before being treated with the dexamethasone implant combined with half fluence PDT performed after one week. She showed benefit for a period of about five months before developing recurrence of intraretinal fluid and decreased vision.
Dr. de Smet reported that over the next three to four years, she was successfully maintained on treatment with the dexamethasone implant, administered about every six to eight months. The treatment was well-tolerated. The patient developed a cataract and underwent successful cataract surgery.