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Treatment for Macular Oedema

It is used for patients with reduced vision due to swelling in the centre of the retina (the macula), known as macular oedema. It can be used for any cause of macular oedema including: diabetic macular oedema, macular oedema secondary to retinal vein occlusion, macular oedema secondary to any type of uveitis or inflammation in the eye.

The major benefit over anti-VEGF injections is that 1 Ozurdex injection lasts for 4 months, so only 1 injection is required compared to 4 anti-VEGF injections over a 4 month period. It is extremely potent and so leads to a more rapid resolution of oedema rather than the oedema reducing gradually over the course of multiple anti-VEGF injections. It works in eyes after vitrectomy, unlike anti-VEGF. It is better for inflammatory causes and is the drug of choice for uveitis. It does not cause any side effects on the rest of the body unlike oral Prednisolone and other medicines used for uveitis, ie it targets the precise part of the body needed to treat rather than causing any systemic side effects. It is better than ant-VEGF in longstanding disease, giving a rapid answer about whether treatment of the macular oedema would improve the vision. It is safe in pregnancy and in patients who have had recent stroke, heart attack or ministroke unlike anti-VEGF which is dangerous in all of these conditions.

Many experts now believe it should be first line in diabetic macular oedema, retinal vein occlusion macular oedema and uveitis macular oedema as it is the drug of choice, works fastest and does not cause cataract when injected once. Once resolution of oedema is achieved quickly with Ozurdex, further treatment can be decided upon by 4 months later.

Mr Peter Addison

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