Title : Intravitreal dexamethasone implant versus ranibizumab versus ranibizumab combined with dexamethasone implant for macular edema secondary to retinal vein occlusion
Abstract:
Purpose: To compare the efficacy of intravitreal injection (IV) ranibizumab, ranibizumab plus dexamethasone implants (R + DEX), and DEX for macular edema secondary to retinal vein occlusion (RVO-ME).
Methods: This was a double-blinded, randomized, comparative study. Two hundred and sixty eyes firstly diagnosed with RVO-ME were randomized into one of five groups according to the medication. The best-corrected visual acuity (BCVA), central retinal thickness (CRT), number of injections (NOI), intraocular pressure (IOP), and cataract were compared at 1, 2, 3, 4, 5, 6, 9, and 12 months postinjection.
Results: At each follow-up, the BCVA was significantly increased in the five groups compared to the baseline, and there was a significant difference between the groups at the last follow-up (p = 0.009). DEX, R + DEX, and ranibizumab successfully reduced CRT at each follow-up. There was a significant difference in the mean decreased CRT between the five groups at the last follow-up (p = 0.03). Both CRVO and BRVO patients had significant between-group differences in the mean NOI (both p < 0.01). The incidence of high IOP and cataract progression were significantly higher in the IVR + DEX and DEX groups than in the ranibizumab group (both p < 0.01).
Conclusion: Early IV of DEX + ranibizumab can provide significantly increased BCVA improvement and decreased CRT for RVO-ME. The advantages of DEX are fewer injections and longer efficacy, while the advantages of ranibizumab include fewer adverse effects.
Keywords: dexamethasone implant, efficacy, macular edema, ranibizumab, retinal vein occlusion
