Intravitreal dexamethasone implant for central retinal vein occlusion without macular edema

Background: To evaluate the efficacy of an intravitreal dexamethasone (IVD) implant (Ozurdex®) for the treatment of central retinal vein occlusion (CRVO) without macular edema (ME). Methods: A retrospective cohort study was designed, and 20 eyes of 20 patients diagnosed with non-ischemic CRVO without ME were included. A total of 10 CRVO eyes were observed without treatment, and another 10 CRVO eyes received a single IVD injection at baseline. Mean changes in pathomorphologic parameters of fundus and optical coherence tomography parameters were measured at baseline and at 1, 3, 6, and 12 months. Results: The decreases in venous tortuosity (p = 0.014 for superior; 0.036 for inferior arcades) and width (p = 0.024 for superior; 0.003 for inferior arcades) from baseline to 12 months after injection were significantly greater in the treated group than the observed group. The improvements in RNFL swelling (p = 0.010) and retinal hemorrhage (p = 0.006) were also significantly greater in the treated group. Visual symptom improvement was significantly faster in the treated group (p = 0.001). In two cases, IVD injection resulted in complete resolution of cilioretinal artery occlusion associated with the CRVO, leading to complete visual recovery in 1 week. None of the treated eyes showed signs of ME development, ischemia progression, or neovascularization. Conclusions: IVD implant was significantly effective in improving venous engorgement, retinal hemorrhage, RNFL swelling, and visual symptoms by presumed alleviation of disc swelling and venous outflow. This treatment may be a considerable treatment option in CRVO patients with no ME.