Comparison of the effects of intravitreal aflibercept and ranibizumab on optical coherence tomography findings in macular edema secondary to retinal vein occlusion.

OBJECTIVE

To compare the effects of intravitreal aflibercept (IVA) and intravitreal ranibizumab (IVR) on optical coherence tomography (OCT) parameters for patients with macular edema (ME) secondary to retinal vein occlusion (RVO).

MATERIALS AND

METHODS

This retrospective study included 70 eyes of 70 patients diagnosed with RVO who attended the Department of Ophthalmology between February 2013 and March 2020. The patients received either IVA or IVR injections and were followed for at least 6 months. Demographic data, systemic comorbidities, best-corrected visual acuity (BCVA), and OCT parameters before and at 1 and 6 months after injection were evaluated. Longitudinal changes were analyzed using repeated-measures general linear models, and multivariable linear regression analyses were performed to adjust for potential confounding factors.

RESULTS

The IVA group exhibited a significantly greater reduction in central macular thickness (CMT) at 6 months compared to the IVR group (p = 0.032). The decrease in the horizontal diameter of the largest intraretinal cyst (IRC) was more prominent in the IVA group at 1 month (p = 0.043). A greater reduction in the disorganization of the retinal inner layer (DRIL) width was also observed in the IVA group at 6 months (p = 0.009). No significant differences were detected between the groups regarding the hyperreflective foci (HRF) count, subretinal fluid (SRF) vertical height, ellipsoid zone (EZ) integrity, external limiting membrane (ELM) integrity, or epiretinal membrane (ERM) presence. Multivariable analyses identified baseline CMT, and RVO subtype for DRIL, rather than treatment group, as independent predictors of anatomical improvement.

CONCLUSION

Both agents demonstrated comparable effects on OCT biomarkers and visual acuity. Larger, prospective studies with longer follow-up periods are warranted to validate these findings.