J Korean Ophthalmol Soc JKOS Journal of the Korean Ophthalmological Society 0378-6471 2092-9374 The Korean Ophthalmological Society 10.3341/jkos.2019.60.9.843 Original Article The Effect of Epiretinal Membrane on Dexamethasone Implant for Branch Retinal Vein Occlusion Macular Edema Jang Mirinae MD 1 Kim Jin Young MD 1 Lee Sang-Yoon MD 1 Jeong Jin Ho MD PhD 1 Lee Eun Kyoung MD 1 2 Department of Ophthalmology, Jeju National University School of Medicine, Jeju, Korea. Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Korea Address reprint requests to Eun Kyoung Lee, MD. Department of Ophthalmology, Seoul National University Hospital, #101 Daehak-ro, Jongno-gu, Seoul 03080, Korea. Tel: 82-2-2072-2053, Fax: 82-2-741-3187, righthanded8282@gmail.com 09 2019 18 09 2019 60 9 843 850 12 02 2019 11 04 2019 16 08 2019 ©2019 The Korean Ophthalmological Society 2019 The Korean Ophthalmological Society This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. Purpose

To evaluate the effect of epiretinal membrane (ERM) on the outcomes of intravitreal dexamethasone implant (Ozurdex®, Allergan, Irvine, CA, USA) treatment for macular edema (ME) secondary to branch retinal vein occlusion (BRVO).

 Methods

Thirty eyes of 30 patients who received Ozurdex treatment for ME secondary to BRVO, and were followed-up for at least 6 months were retrospectively reviewed. Patients were divided into two groups based on the presence (ERM [+] or absence ERM [−]) of ERM at baseline. The best-corrected visual acuity (BCVA), central foveal thickness (CFT), recurrence of ME, and retreatment rate were evaluated at baseline, 1, 3, and 6 months after Ozurdex injection.

 Results

Ten eyes of 30 eyes (33%) showed ERM at baseline. While the mean CFT was significantly reduced at 1 month after Ozurdex injection, it began to increase gradually thereafter in both groups. The ERM (+) group showed a significantly higher mean CFT than the corresponding values of the ERM (−) group at 1 (p = 0.022) and 6 months (p = 0.001) after Ozurdex injection. However, no significant difference was found in the BCVA between the two groups at every visit. The proportion of eyes with ME was significantly higher in the ERM (+) group (90%) than that in the ERM (−) group (35%) at 6 months after Ozurdex injection (p = 0.009). There were no significant differences between the two groups in the percentage of retreatment, time to retreatment, and type of materials used for retreatment.

 Conclusions

In patients with ME secondary to BRVO, the treatment effect of Ozurdex was low and the duration of treatment was short when ERM was concurrently present. However, the presence of ERM did not significantly affect visual outcomes after treatment with Ozurdex.

 Branch retinal vein occlusion Epiretinal membrane Intravitreal dexamethasone implant Macular edema Jeju National University Hospital https://doi.org/10.13039/501100008126

The authors have no conflicts to disclose.

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(A) The eye without epiretinal membrane (ERM) showed severe macular edema at baseline. After Ozurdex injection, no significant recurrence was observed during the 6-month of follow-up period. (B) The eye with ERM also showed significant macular edema at baseline. The macular edema absorbed at 1 month after Ozurdex injection but recurred at 3 months. At 3 months, an additional injection of bevacizumab was performed, but the macular edema persisted at 6 months. Chronological changes in mean central foveal thickness (CFT) (A) and best-corrected visual acuity (BCVA) (B) in ERM (−) and ERM (+) groups. (A) The ERM (+) group showed significantly higher mean CFT at 1 and 6 months after Ozurdex injection than the corresponding values of ERM (−) group. (B) There were no significant differences in BCVA between the two groups at every visit. <sup>*</sup><italic>p</italic><0.05, <sup>**</sup><italic>p</italic><0.01 for comparisons between groups at each follow-up visit. The proportion of eyes with macular edema in ERM (−) and ERM (+) groups. It was significantly higher in ERM (+) group than that of ERM (−) group at 6 months after Ozurdex injection. ME = macular edema. <sup>*</sup><italic>p</italic> < 0.01 for comparisons between groups at each follow-up visit. Demographics and baseline characteristics of included patients

Values are presented as mean ± standard deviation or number.

ERM (−) group = eyes without epiretinal membrane; ERM (+) group = eyes with epiretinal membrane; CFT = central foveal thickness; BCVA = best-corrected visual acuity; logMAR = logarithm of the minimal angle of resolution.

*Pearson's chi-squared test, †Mann-Whitney U-test.

 Mean changes in central foveal thickness

Values are presented as mean ± standard deviation.

ERM (−) group = eyes without epiretinal membrane; ERM (+) group = eyes with epiretinal membrane.

*Mann-Whitney U-test; †p < 0.05.

 Mean changes in best-corrected visual acuity

Values are presented as mean ± standard deviation.

BCVA = best-corrected visual acuity; logMAR = logarithm of the minimal angle of resolution; ERM (−) group = eyes without epiretinal membrane; ERM (+) group = eyes with epiretinal membrane.

*Mann-Whitney U-test.

 Retreatment summary

Values are presented as mean ± standard deviation or number (%).

ERM (−) group = eyes without epiretinal membrane; ERM (+) group = eyes with epiretinal membrane.

*Pearson's chi-squared test; †Mann-Whitney U-test.