“Mr. Ozurdex” is a patient in whom I injected Ozurdex® for the treatment of a branch retinal vein occlusion (BRVO). Ozurdex, is the first sustained release drug delivery system for the eye. It was FDA approved for the treatment of retinal vein occlusions last summer (RVO). Allergan began marketing Ozurdex shortly after the FDA approval.
Mr. Ozurdex was given an intraocular injection in early January. Upon his first return visit, he noted a dramatic improvement in his vision! At the time of injection, he was legally blind. After only 2 weeks, his vision improved enough to read.
Upon his return this week, his vision remains stable, he can still read and there are no concerns of any complications. As with any injection of steroid, in increase in eye pressure may occur. Happily, there is none.
Mrs. Ozurdex is Still Worried
“Mrs. Ozurdex,” on the other hand, is still not seeing any differently. About the same time, I injected Ozurdex for treatment of a central retinal vein occlusion (CRVO). There are two types of retinal vein occlusions; central (CRVO) and branch (BRVO).
Mr. “O” had a BRVO. The visual prognosis has always been better with a branch retinal vein occlusion.
Mrs. “O” had a CRVO. The visual prognosis has always been much poorer with a central retinal vein occlusion.
Early Visual Results May be Misleading
I have cautioned both patients. First, with Mr. Ozurdex, while the results are fantastic, the real question is whether or not we can sustain this improvement. He may require another injection of Ozurdex, plain steroid, or even anti-VEGF, such as Avastin.
I have encouraged Mrs. Ozurdex to remain positive. First, she is no worse than when we decided on the sustained release therapy, and second, the drug will be released for several more months to come. There is still a great deal of blood and edema that can resolve, so who is to say how well she’ll fare over the next four months?
What Does This Mean? It is exciting to try a new therapy especially in an area where there have traditionally been few therapeutic options. It is also easy to be biased, good or bad, about the results of a new treatment.
I have no way of really knowing if every patient is going to respond like Mr. “O.” We have yet to define the perfect patient for receiving the new steroid releasing device, perhaps everyone will.
It’s too early to tell if Mrs. “O” is exhibiting a typical or atypical response to Ozurdex given her condition.
Though the FDA has given its approval, it doesn’t necessarily translate into a positive outcome.