Short-term effects of intravitreal dexamethasone implant (OZURDEX®) on choroidal thickness in patients with naive branch retinal vein occlusion / Os efeitos a curto prazo do implante de dexametasona intravítrea (OZURDEX®) na espessura da coroide em pacientes com oclusão primária de ramo da veia central da retina

ABSTRACT Purpose: The objective of this study was to evaluate subfoveal choroidal thickness (SFCT) using enhanced depth imaging optical coherence tomography (EDI-OCT) in patients with naïve branch retinal vein occlusion (BRVO) before and after intravitreal dexamethasone implant (Ozurdex®) injection. Methods: Thirty-nine patients with unilateral BRVO and 35 healthy subjects were included in this prospective study. Choroidal thickness was evaluated by EDI-OCT at baseline and 1 month after dexamethasone implant. Results: The mean SFCT measured in 39 patients with BRVO was 299.41 ± 55.86 µm, significantly greater than that in contralateral eyes (283.76 ± 57.44 µm; p=0.009) and control eyes (276.14 ± 39.06 µm; p=0.044). The mean SFCT after the treatment was 279.64 ± 50.96 µm, significantly thinner than that before intravitreal dexamethasone therapy (p=0.004). Conclusions: SFCT in treatment-naive BRVO eyes was significantly greater than that in contralateral eyes and healthy eyes and decreased significantly after intravitreal dexamethasone implantation.

RESUMO Objetivo: O objetivo deste estudo foi avaliar a espessura da coróide (SFCT) usando imagens de tomografia de coerência óptica com profundidade aprimorada (EDI-OCT) no tratamento de pacientes com oclusão primária de ramo da veia central da retina (BRVO) antes e após o implante de dexametasona intravítrea (Ozurdex®). Métodos: Trinta e nove pacientes com BRVO unilateral e 35 indivíduos saudáveis foram incluídos neste estudo prospectivo. Espessura da coróide foi avaliada por EDI-OCT na antes e um mês após o tratamento. Resultados: A média da SFCT medida em 39 pacientes com BRVO foi 299,41 ± 55,86 µm, o que foi significativamente maior do que a dos olhos contralaterias (283,76 ± 57,44 µm) e dos olhos controle (276,14 ± 39,06 µm) (p=0,009 e p=0,044, respectivamente). A média da SFCT após o tratamento foi 279,64 ± 50,96 µm, o que foi significativamente menor do que antes do mesmo (p=0,004). Conclusões: A SFCT do tratamento de olhos com BRVO primária foi significativamente maior do que a dos olhos contralaterais e dos olhos saudáveis, e diminuiu significativamente após o implante intravítreo de dexametasona.

Comparison of ocular response analyzer parameters in primary open angle glaucoma and exfoliative glaucoma patients.

Aim: We sought to identify differences in the following measures of the ocular response analyser (ORA) between primary open angle glaucoma (POAG) and exfoliative glaucoma (EXG) patients: Corneal hysteresis (CH), corneal resistance factor (CRF), corneal‑compensated intraocular pressure (IOPcc) and Goldmann‑correlated intraocular pressure (IOPg). We also sought to relate these ORA measures with central corneal thickness (CCT). Materials and Methods: This cross‑sectional study was conducted on a total of 162 individuals (46 EXG patients, 66 POAG patients and 50 healthy subjects without any ocular and systemic disease). ORA measurements were performed, and a minimum of three readings were obtained from each test subject. Groups were compared according to their ORA parameters. Results: The mean CH levels of the EXG, POAG and healthy subjects were 7.6 ± 2.1, 9.1 ± 1.9 and 9.6 ± 1.7 mmHg, respectively. CH was significantly lower in the EXG patients compared to the other groups (P < 0.001).The mean CRF levels of the EXG, POAG and healthy subjects were 9.0 ± 2.0, 10.1 ± 1.7 and 9.8 ± 1.8mmHg, respectively. CRF levels in the eyes of the EXG patients were significantly lower compared to those of either the POAG patients (P = 0.005) or the healthy subjects (P = 0.03), but there was no significant difference in CRF levels between the POAG patients and the healthy subjects (P = 0.59). There was a significant positive correlation between CH and CCT in the EXG patients and healthy subjects (P < 0.001), but this correlation was not present in the POAG patients (P = 0.70). Conclusions: In this study, CH and CRF were found to be significantly reduced in the eyes of EXG patients compared to both the POAG patients and healthy subjects. Reduced CH in EXG patients might result in decreased support of peripapillary scleral structure and increased damage to the optic nerve during IOP increase.