The Structural and Comparative Analysis of Intravitreal Dexamethasone Implant (Ozurdex) and Anti-VEGF Injection in Branched Retinal Vein Occlusion Patients by Optical Coherence Tomography Angiography Images Quantitation.

Background and

Objective

To evaluate and compare the structural changes of retinal vasculature after intravitreal dexamethasone implant (Ozurdex) insertion and antivascular endothelial growth factor (anti-VEGF) injection in patients with branched retinal vein occlusion (BRVO) using optical coherence tomography angiography (OCTA).Study Design/Materials and

Methods

We retrospectively analyzed 39 patients with unilateral BRVO. Subjects were divided into two groups according to treatment agent: Ozurdex (n = 18) and anti-VEGF (n = 21). Swept Source (SS) OCT and OCTA were performed and images were analyzed quantitatively using ImageJ (National Institutes of Health) software. Intravitreal implant and anti-VEGF injections were performed following a prn regimen. The specific anti-VEGF agent used was chosen among bevacizumab, ranibizumab and aflibercept.

Results

Of the 39 patients (mean ± SD age, 70.0 ± 8.9 years [range, 48-89 years]; 20 men [51.0%]) with unilateral BRVO, in an independent two-sample t test, there was greater vascular reperfusion of the choriocapillaris slab in the intravitreal Ozurdex implant group than in the anti-VEGF group using the angiography mode (P = .013). Increased number of particles was more prominent in intravitreal anti-VEGF injection group than intravitreal Ozurdex implant group in outer retina slab of En-face mode (P = .039). There was no statistically significant difference between the 2 treatment groups in relation to the Early Treatment Diabetic Retinopathy Study (ETDRS) density map and other angiography slabs; and the superficial, deep, and outer retina.

Conclusions

Results of a quantitative analysis of OCTA images using ImageJ software suggest that the intravitreal Ozurdex implant induced increased retinal vascular perfusion compared with anti-VEGF injection for the treatment of BRVO.