Prospective evaluation of the effectiveness of combined treatment of macular edema secondary to retinal vein occlusion with intravitreal bevacizumab and dexamethasone implants

• Published in: Arquivos brasileiros de oftalmologia Vol. 86; no. 3; pp. 255 - 262
• Main Authors: Moreno-López, María, de-Arriba-Palomero, Pablo, de-Arriba-Palomero, Fernando, Ituruburu, Federico Peralta, Dompablo, Elisabet de, Negrete, Francisco José Muñoz
• Format: Journal Article
• Language: English
• Published: Brazil Conselho Brasileiro de Oftalmologia 01.05.2023
• Subjects: Bevacizumab - therapeutic use; Dexamethasone; Drug Implants - therapeutic use; Glucocorticoids; Humans; Intravitreal Injections; Macular Edema - drug therapy; Macular Edema - etiology; OPHTHALMOLOGY; Retinal Vein Occlusion - complications; Retinal Vein Occlusion - drug therapy; Tomography, Optical Coherence; Treatment Outcome; Dexametasona/administração & dosagem; Intravitreal Injections; Injeções intravítreas; Visual acuity; Retinal vein occlusion/complications; Oclusão da veia retiniana/complicações; Bevacizumab; Edema macular/tratamento farmacológico; Macular edema/drug therapy; Angiogenesis inhibitors/ therapeutic use; Inibidores de angiogênese/uso terapêutico; Tomography; Acuidade visual; optical coherence; Tomografia de coerência óptica; Dexamethasone/ administration & dosage
• ISSN: 0004-2749; 1678-2925; 1678-2925
• DOI: 10.5935/0004-2749.20230040

To evaluate the effectiveness of in---travitreal bevacizumab injections following a single dexamethasone implant in the treatment of macular edema secondary to branch and central retinal vein occlusion. This was a prospective interventional non-comparative study, 44 eyes of patients with naïve macular edema related to branch and central retinal vein occlusion were treated with a dexamethasone implant. Patients were followed-up at four-week intervals from the second to the sixth month. If persistent or recurrent macular edema occurred during this period, the patient was treated with intravitreal bevacizumab injections on an as-needed basis. The outcome measures were best-corrected visual acuity and central macular thickness changes. The mean best-corrected visual acuity changed from 0.97 ± 0.33 LogMAR at baseline to 0.54 ± 0.40 at the six-month post-implant examination (p<0.00001). Improvement ≥3 Snellen lines were seen in 20 eyes (45.54%). The mean central macular thickness at baseline was 670.25 ± 209.9 microns. This had decreased to 317.43 ± 112.68 microns at the six-month follow-up (p<0.00001). The mean number of intravitreal bevacizumab injections received in the six months post-implant was 2.32. The mean time from dexamethasone implant to first anti-VEGF injection was 3.45 months. Intravitreal bevacizumab injections following a single dexamethasone implant were found to improve best-corrected visual acuity and central macular thickness in patients with macular edema due to branch and central retinal vein occlusion at six months, with few intravitreal injections required.