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Corticosteroid — Intravitreal Biodegradable Implant Pregnancy: There are no adequate data from the use of intravitreally administered dexamethasone in pregnant women, and animal studies have shown teratogenic effects following topical ophthalmic administration. Long-term systemic glucocorticoid treatment in pregnancy increases the risk of intra-uterine growth retardation and adrenal insufficiency in the newborn; although systemic exposure after local intraocular treatment would be expected to be very low, the implant is not recommended during pregnancy unless the potential benefit justifies the potential risk to the foetus. Dexamethasone is excreted in breast milk and, while no effects on the child are anticipated given the route of administration and resulting systemic levels, the implant is not recommended during breast feeding unless clearly necessary. No fertility data are available.

Dexamethasone Intravitreal Implant 0.7 mg

Brand names: Ozurdex

The dexamethasone intravitreal implant is a sustained-release corticosteroid device injected into the vitreous to treat conditions such as macular oedema secondary to retinal vein occlusion, diabetic macular oedema and non-infectious posterior uveitis.

Adult dose

Dose: One OZURDEX 700 microgram dexamethasone intravitreal implant administered intravitreally into the affected eye. The SPC gives this single dose for all of the product's indications — diabetic macular oedema (DME), macular oedema following branch retinal vein occlusion (BRVO) or central retinal vein occlusion (CRVO), and non-infectious uveitis affecting the posterior segment of the eye.
Route: Intravitreal injection into the affected eye from the single-use pre-loaded applicator, given by a qualified healthcare professional experienced in intravitreal injections. The procedure is carried out under controlled aseptic conditions (sterile gloves, sterile drape and sterile eyelid speculum or equivalent) with adequate local anaesthesia, after disinfection of the periocular skin, eyelid and ocular surface (for example povidone iodine 5% solution on the conjunctiva). Each applicator may be used for one eye only.
Frequency: One implant per treatment. DME: retreatment may be performed after approximately 6 months if the patient experiences decreased vision and/or an increase in retinal thickness secondary to recurrent or worsening diabetic macular oedema, in patients who had an initial response and who in the physician's opinion may benefit from retreatment without being exposed to significant risk. RVO and uveitis: repeat doses should be considered when a patient experiences a response followed subsequently by a loss in visual acuity and in the physician's opinion may benefit from retreatment without significant risk; patients who experience and retain improved vision should not be retreated, and patients whose deterioration in vision is not slowed by the implant should not be retreated. Administration to both eyes concurrently is not recommended.
Max: One implant per affected eye per administration; concurrent administration to both eyes is not recommended
Indication scope: the fetched SPC covers DME, macular oedema following BRVO or CRVO, and non-infectious uveitis of the posterior segment; the dose is the same for all three. Retreatment limits stated in the SPC: there is currently no experience of the efficacy or safety of repeat administrations in DME beyond 7 implants, and there is only very limited information on repeat dosing intervals of less than 6 months. Antimicrobial cover: the patient should be instructed to self-administer broad spectrum antimicrobial drops daily for 3 days before and after each injection, and to continue antimicrobial drops following the injection. Confirmation of placement: immediately after injecting, use indirect ophthalmoscopy in the quadrant of injection to confirm successful implantation; if the implant cannot be visualised, lightly depress over the injection site with a sterile cotton bud to bring it into view. Special populations (SPC section 4.2): elderly aged 65 years and over need no dose adjustment; the implant has not been studied in renal or hepatic impairment but no special considerations are needed in either; there is no relevant use in the paediatric population in DME or in macular oedema following BRVO or CRVO, and safety and efficacy in paediatric uveitis have not been established (no data available) — see paedDose. Implant migration: all patients with a posterior capsule tear and/or an iris opening to the vitreous cavity are at risk of implant migration into the anterior chamber, which may cause corneal oedema and/or corneal decompensation; where not contraindicated outright, use only after careful risk-benefit assessment with close monitoring. SOURCE COMPLETENESS: section 4.2 was retrieved in full, but sections 4.4 and 4.8 of this bundle end at the source-fetch limit, so the warnings and adverse-effect lists below are partial and are not a complete account of the label.

Dose independently re-sourced from UK Summary of Product Characteristics (SPC) via the eMC — clinician-reviewed. Always confirm against the product SmPC and your local formulary before prescribing.

Contraindications

  • Hypersensitivity to the active substance or to any of the excipients listed in section 6.1
  • Active or suspected ocular or periocular infection, including most viral diseases of the cornea and conjunctiva, active epithelial herpes simplex keratitis (dendritic keratitis), vaccinia, varicella, mycobacterial infections and fungal diseases
  • Advanced glaucoma which cannot be adequately controlled by medicinal products alone
  • Aphakic eyes with ruptured posterior lens capsule
  • Eyes with an anterior chamber intraocular lens (ACIOL), or an iris- or transscleral-fixated intraocular lens, and a ruptured posterior lens capsule

Side effects

  • Very common: increased intraocular pressure, cataract, conjunctival haemorrhage
  • Common: headache, ocular hypertension, subcapsular cataract, vitreous haemorrhage, reduced visual acuity, visual impairment or disturbance, vitreous detachment, vitreous floaters, vitreous opacities, blepharitis, eye pain, photopsia, conjunctival oedema, conjunctival hyperaemia
  • Uncommon: migraine, necrotizing retinitis, endophthalmitis, glaucoma, retinal detachment, retinal tear, hypotony of the eye, anterior chamber inflammation, anterior chamber cells or flares, abnormal sensation in the eye, eyelid pruritus, scleral hyperaemia
  • Uncommon: device dislocation (migration of the implant) with or without corneal oedema or corneal decompensation, and complication of device insertion resulting in ocular tissue injury (implant misplacement)
  • Intravitreous injections, including with this implant, can be associated with endophthalmitis, intraocular inflammation, increased intraocular pressure and retinal detachment
  • Corticosteroid class effects: cataract including posterior subcapsular cataract, increased intraocular pressure, steroid-induced glaucoma and secondary ocular infections. In the 3-year DME clinical studies, 59% of patients with a phakic study eye underwent cataract surgery in the study eye
  • This side-effect list may be incomplete — check the full SPC.

Monitoring

  • Monitor the patient following each injection to permit early treatment if an infection or increased intraocular pressure occurs
  • Check perfusion of the optic nerve head immediately after the injection
  • Tonometry within 30 minutes following the injection
  • Biomicroscopy between two and seven days following the injection
  • Instruct the patient to report without delay any symptoms suggestive of endophthalmitis or of the events above, for example eye pain or blurred vision
  • Monitor closely for device migration in patients with a posterior capsule tear and/or an iris opening to the vitreous cavity, to allow early diagnosis and management

Clinical monograph

How it works

The biodegradable implant gradually releases dexamethasone within the eye, suppressing inflammation and reducing vascular permeability to lessen retinal oedema.

Prescribing in practice

  • It must be administered by an appropriately trained ophthalmologist under aseptic conditions, with patients warned to report symptoms of endophthalmitis or retinal detachment without delay.
  • It commonly raises intraocular pressure and accelerates cataract formation, and is contraindicated in active or suspected ocular or periocular infection and in advanced glaucoma.
  • Caution is required in eyes with a compromised posterior lens capsule, as the implant may migrate into the anterior chamber.

Monitoring

Monitor intraocular pressure and assess for infection, raised pressure and lens changes following injection.

Counselling the patient

  • Seek urgent ophthalmic care if you develop eye pain, increasing redness, reduced vision or increased sensitivity to light.
  • Floaters may increase temporarily after the injection.
  • Attend all scheduled reviews so your eye pressure and retina can be checked.

Evidence & guidelines

Use in retinal vein occlusion-related and diabetic macular oedema and non-infectious uveitis is supported by NICE technology appraisals and randomised trial evidence.

Reference: NICE TA229; NICE TA349; NICE TA409; MACULAR Trial; SPC Ozurdex; Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. The structured dose values shown have been reviewed by a clinician. Monograph status: clinician-reviewed (2026-07-04).

Related

Curated clinical cross-links plus same-class fallbacks.

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