A comparison of three different intravitreal treatment modalities of macular edema due to branch retinal vein occlusion
INTERNATIONAL OPHTHALMOLOGY, vol.38, no.4, pp.1549-1558, 2018 (SCI-Expanded, Scopus)
- Publication Type: Article / Article
- Volume: 38 Issue: 4
- Publication Date: 2018
- Doi Number: 10.1007/s10792-017-0618-z
- Journal Name: INTERNATIONAL OPHTHALMOLOGY
- Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus
- Page Numbers: pp.1549-1558
- Keywords: Aflibercept, Branch retinal vein occlusion, Dexamethasone implant, Ranibizumab, Serous retinal detachment, ENDOTHELIAL GROWTH-FACTOR, DEXAMETHASONE IMPLANT, 12-MONTH OUTCOMES, VITREOUS LEVELS, AQUEOUS-HUMOR, STANDARD-CARE, RANIBIZUMAB, SECONDARY, TRIAMCINOLONE, INTERLEUKIN-6
- Inonu University Affiliated: Yes
Abstract
Abstract
PURPOSE:
To compare the efficacy of intravitreal injection of ranibizumab, dexamethasone implant and aflibercept for the management of macular edema (ME) related to branch retinal vein occlusion (BRVO).
METHODS:
This retrospective and comparative study included 62 eyes of 62 patients with BRVO and ME. Patients received one of the following treatments: 0.5 mg ranibizumab (group 1, n = 22), 0.7 mg dexamethasone implant (group 2, n = 20) and 2 mg aflibercept (group 3, n = 20). The 6-month treatment protocol in groups 1 and 3 consisted of 3-dose loading treatment for the first 3 months and followed by repeat injections based on clinical necessity. Group 2 received only single dose of 0.7 mg dexamethasone implant for 6 months. Visual acuity (VA), central macular thickness (CMT), serous retinal detachment (SRD) height and intraocular pressure (IOP) measurements were done at baseline and first 6 months of follow-up.
RESULTS:
At baseline, the groups did not differ in age, gender, duration of ME, VA, CMT, IOP and SRD height (p > 0.05). Mean number of injections per eye within six months were 3.64 ± 0.49 (range 3-4) in group 1, only 1 in group 2 and 3.35 ± 0.49 (range 3-4) in group 3.VA was significantly better in group 2 in first 3 months but it became the worst among three groups in sixth month. CMT did not differ between groups in first 3 months, but it was significantly higher in group 2 at sixth month. SRD height was significantly lower in group 2 in first 3 months, but there was no difference between the groups at the end of the sixth month. IOP was significantly higher in group 2 in third and sixth months.
CONCLUSION:
In the treatment of ME associated with BRVO, dexamethasone implant appears to be more advantageous in terms of VA and SRD height for the first 3 months. However, at the end of the sixth month of treatment, anti-VEGF drugs were more efficient in maintaining the increased visual acuity and reduced CMT. A dexamethasone implant may be the first treatment option in BRVO cases with high SRD.
KEYWORDS:
Aflibercept; Branch retinal vein occlusion; Dexamethasone implant; Ranibizumab; Serous retinal detachment