Sustained Release DexamethasoneIntravitreal Implant Device in Management of MacularEdema Secondary to Retinal Vein Occlusion

Abstract

The past several years have borne witness to several advances in the treatment of ME secondary to RVO. For the first time, new treatment modalities offer alternatives to observation and LC, namely the prolonged use of corticosteroid and anti- VEGF medications. The DEX DDS is one of the most recent developments, and is intriguing for its therapeutic potency, broad spectrum of activity, dose consistency, potential for extended duration of action, and apparently improved safety profile compared with IVTA. In particular, the DEX DDS has evidence for efficacy in multiple clinical situations. In addition to their clinical role, one of the questions commonly asked is whether the therapeutic benefit of the available new pharmacological options for macular edema secondary to retinal vein occlusion justify their cost. It is clearly inappropriate to simply compare medications based on their retail cost alone, given the numerous other expenses that should be considered in a robust cost analysis (e.g., the cost of a follow-up appointment, the cost to patients for missing work and/or getting to their appointment, the cost of administering an intravitreal injection, and the cost of different side effect profiles).