DEXAMETHASONE IMPLANT FOR MACULAR EDEMA SECONDARY TO ISCHEMIC RETINAL VEIN OCCLUSIONS.

PURPOSE: To evaluate the effects of dexamethasone implant for the treatment of macular edema secondary to ischemic retinal vein occlusions (IRVO). METHODS: Consecutive patients affected by macular edema related to IRVO were prospectively recruited. After a comprehensive ophthalmological examination, including visual acuity, fluorescein angiography, and optical coherence tomography, each patient received a first implant. Further re-treatments were performed on the basis of macular edema detection from the fourth month on. The primary outcome measure was the change in Early Treatment Diabetic Retinopathy Study letter score at the 12-month examination. Secondary outcome measures included changes in central foveal thickness and number of implants over the follow-up. RESULTS: Fifteen patients with central IRVO and 14 patients with branch IRVO were recruited. The median ETDRS letter score at baseline was 10 (Snellen Equivalent 20/640) in the central IRVO subgroup, improving to 37 (Snellen Equivalent 20/200²âº) at the 12-month examination. The median ETDRS letter score in the branch retinal vein occlusion subgroup changed from 48 (Snellen equivalent 20/125³âº) at baseline to 62 (Snellen equivalent 20/63²âº) at the 12-month examination. The baseline median central foveal thickness was 749 µm in central IRVO, and 459 µm in branch IRVO, improving to 363 µm and 323 µm, respectively, at the 12-month examination. Mean number of implants was 2.8 in the central IRVO and 2 in the branch IRVO. CONCLUSION: Dexamethasone implant can reduce macular edema in eyes affected by IRVO, leading to a slight improvement in visual acuity.

Photosensitizers and Photodynamic Therapy: Verteporfin.

Photodynamic therapy (PDT) is a phototherapy in which a photosensitive dye is injected into a peripheral vein and activated by light in order to occlude choroidal vessels or change their permeability. PDT has been largely applied in the treatment of choroidal neovascularization (CNV), especially CNV related to age-related macular degeneration, but was also of benefit in other diseases, including central serous chorioretinopathy and choroidal hemangioma.

Retinal Hereditary and Degenerative/Dystrophic Diseases (Non-Age-Related Macular Degeneration).

The definition of hereditary retinal diseases includes heterogeneous conditions leading to significant visual impairment. Great strides are being made in the management of many of these dystrophies, with many ongoing trials aiming to ascertain if a pharmacological therapy can reverse or at least stop the natural course of these disorders. In addition, good results have also been achieved in the treatment of typical complications of inherited dystrophies such as cystoid macular edema and choroidal neovascularization.