Bevacizumab versus Dexamethasone Implant Followed by Bevacizumab for the Treatment of Macula Edema Associated with Branch Retinal Vein Occlusion
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To compare visual and anatomical outcomes of intravitreal injections of bevacizumab and dexamethasoneimplant (Ozurdex) treatment for macular edema associated with branch retinal vein occlusion (BRVO). Methods: We retrospectively reviewed patients who underwent intravitreal bevacizumab administered monthlyon a pro re nata (PRN) basis (26 eyes, IVB group) or an initial 700-μg dexamethasone implant followed by abevacizumab PRN injection (20 eyes, IVD group) for treatment of macular edema associated with BRVO. Wecompared best-corrected visual acuity (BCVA) and central macular thickness (CMT). We also measured ellipsoidzone recovery rate and ganglion cell-inner plexiform layer volume within the center 6 mm zone. A linearmixed model analysis was performed to compare serial changes in BCVA and CMT. Results: Both groups showed significant improvement in BCVA and significant reduction in CMT. However,BCVA in the first month was significantly better in the IVD group (logarithm of the minimum angle of resolution,IVD group 0.21 ± 0.26 vs. IVB group 0.39 ± 0.30, p = 0.038) and the 1-month CMT was thinner in the IVDgroup (IVD group 270.0 ± 62.0 μm vs. IVB group 338.9 ± 122.6 μm, p = 0.028), and these trends were maintainedduring the 6-month follow-up. The IVD group showed more rapid macular edema resolution (p = 0.049);however, there were no significant differences in ellipsoid zone recovery rate (p = 0.268) or ganglion cell-innerplexiform layer volume between the two groups (p = 0.459). Conclusions: There were no significant differences in final visual or anatomical outcomes between the twogroups; however, initial dexamethasone implant injection followed by bevacizumab PRN injection initiallyshowed more rapid improvement in vision and BRVO-associated macular edema resolution compared to intravitrealbevacizumab administered monthly on a PRN basis.
Abstract
To compare visual and anatomical outcomes of intravitreal injections of bevacizumab and dexamethasoneimplant (Ozurdex) treatment for macular edema associated with branch retinal vein occlusion (BRVO). Methods: We retrospectively reviewed patients who underwent intravitreal bevacizumab administered monthlyon a pro re nata (PRN) basis (26 eyes, IVB group) or an initial 700-μg dexamethasone implant followed by abevacizumab PRN injection (20 eyes, IVD group) for treatment of macular edema associated with BRVO. Wecompared best-corrected visual acuity (BCVA) and central macular thickness (CMT). We also measured ellipsoidzone recovery rate and ganglion cell-inner plexiform layer volume within the center 6 mm zone. A linearmixed model analysis was performed to compare serial changes in BCVA and CMT. Results: Both groups showed significant improvement in BCVA and significant reduction in CMT. However,BCVA in the first month was significantly better in the IVD group (logarithm of the minimum angle of resolution,IVD group 0.21 ± 0.26 vs. IVB group 0.39 ± 0.30, p = 0.038) and the 1-month CMT was thinner in the IVDgroup (IVD group 270.0 ± 62.0 μm vs. IVB group 338.9 ± 122.6 μm, p = 0.028), and these trends were maintainedduring the 6-month follow-up. The IVD group showed more rapid macular edema resolution (p = 0.049);however, there were no significant differences in ellipsoid zone recovery rate (p = 0.268) or ganglion cell-innerplexiform layer volume between the two groups (p = 0.459). Conclusions: There were no significant differences in final visual or anatomical outcomes between the twogroups; however, initial dexamethasone implant injection followed by bevacizumab PRN injection initiallyshowed more rapid improvement in vision and BRVO-associated macular edema resolution compared to intravitrealbevacizumab administered monthly on a PRN basis.
참고문헌 (26)
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