International ophthalmology · 2017
A comparison of three different intravitreal treatment modalities of macular edema due to branch retinal vein occlusion.
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Kaldırım Havva Erdogan, Yazgan Serpil
Аннотация
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.
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.
Предметные рубрики MeSH
AgedAnalysis of VarianceAngiogenesis InhibitorsAnti-Inflammatory AgentsDexamethasoneDrug Therapy, CombinationHumansIntraocular PressureIntravitreal InjectionsMacular EdemaRanibizumabReceptors, Vascular Endothelial Growth FactorRecombinant Fusion ProteinsRetinal Vein OcclusionRetrospective StudiesVisual Acuity