Pro-Permeability Factors After Dexamethasone Implant in Retinal Vein Occlusion; the Ozurdex for Retinal Vein Occlusion (ORVO) Study. Am J Ophthalmol 2015 Aug;160(2):313-321.e19
Date
04/25/2015Pubmed ID
25908486Pubmed Central ID
PMC6600806DOI
10.1016/j.ajo.2015.04.025Scopus ID
2-s2.0-84937513600 (requires institutional sign-in at Scopus site) 39 CitationsAbstract
PURPOSE: To correlate aqueous vasoactive protein changes with macular edema after dexamethasone implant in retinal vein occlusion (RVO).
DESIGN: Prospective, interventional case series.
METHODS: Twenty-three central RVO (CRVO) and 17 branch RVO (BRVO) subjects with edema despite prior anti-vascular endothelial growth factor (VEGF) treatment had aqueous taps at baseline and 4 and 16 weeks after dexamethasone implant. Best-corrected visual acuity (BCVA) and center subfield thickness were measured every 4 weeks. Aqueous vasoactive protein levels were measured by protein array or enzyme-linked immunosorbent assay.
RESULTS: Thirty-two vasoactive proteins were detected in aqueous in untreated eyes with macular edema due to RVO. Reduction in excess foveal thickness after dexamethasone implant correlated with reduction in persephin and pentraxin 3 (Pearson correlation coefficients = 0.682 and 0.638, P = .014 and P = .003). Other protein changes differed among RVO patients as edema decreased, but ≥50% of patients showed reductions in hepatocyte growth factor, endocrine gland VEGF, insulin-like growth factor binding proteins, or endostatin by ≥30%. Enzyme-linked immunosorbent assay in 18 eyes (12 CRVO, 6 BRVO) showed baseline levels of hepatocyte growth factor and VEGF of 168.2 ± 20.1 pg/mL and 78.7 ± 10.0 pg/mL, and each was reduced in 12 eyes after dexamethasone implant.
CONCLUSIONS: Dexamethasone implants reduce several pro-permeability proteins providing a multitargeted approach in RVO. No single protein in addition to VEGF can be implicated as a contributor in all patients. Candidates for contribution to chronic edema in subgroups of patients that deserve further study include persephin, hepatocyte growth factor, and endocrine gland VEGF.
Author List
Campochiaro PA, Hafiz G, Mir TA, Scott AW, Sophie R, Shah SM, Ying HS, Lu L, Chen C, Campbell JP, Kherani S, Zimmer-Galler I, Wenick A, Han I, Paulus Y, Sodhi A, Wang G, Qian JMESH terms used to index this publication - Major topics in bold
AgedAged, 80 and over
Dexamethasone
Drug Implants
Enzyme-Linked Immunosorbent Assay
Female
Follow-Up Studies
Glucocorticoids
Humans
Intravitreal Injections
Male
Middle Aged
Permeability
Prospective Studies
Retinal Vein Occlusion
Tomography, Optical Coherence
Treatment Outcome
Visual Acuity
