Real-life clinical data for dexamethasone and ranibizumab in the treatment of branch or central retinal vein occlusion over a period of six months
- 529 Downloads
To evaluate the therapeutic outcome for dexamethasone implant (DEX) or intravitreal ranibizumab (IVR) injections over 6 months in patients with macular edema due to branch or central retinal vein occlusion (BRVO, CRVO), in a real-life setting.
A total of 107 patients with BRVO or CRVO were included into this retrospective single-center observational study. Patients were treated with monotherapy consisting of DEX or three monthly IVR injections following a pro re nata regimen (PRN). Best-corrected visual acuity (BCVA), central retinal thickness (CRT) and intraocular pressure (IOP) were compared between the two therapy groups after 1, 3 and 6 months.
BRVO patients treated with DEX achieved a statistically significant gain in BCVA measured in logMAR after 1 month (mean gain, 95% CI: 0.21, 0.08–0.34, p = 0.001), 3 months (0.16, 0.03–0.28, p = 0.012) and 6 months (0.19, 0.07–0.32, p = 0.002), whereas patients treated with IVR showed a statistically significant BCVA gain in month 3 (mean improvement, 95% CI: 0.13, 0.01–0.26, p = 0.039) and month 6 (0.16, 0.03–0.29, p = 0.018). BCVA in CRVO patients with DEX worsened slightly at month 6 (mean worsening, 95% CI: −0.08, −0.24 to 0.08, p = 0.305), while IVR treated-patients achieved a statistically significant BCVA gain at 3 months (mean improvement, 95% CI: 0.14, 0.02–0.25, p = 0.021). Both therapies were accompanied by statistically significant CRT reductions of 150 to 200 μm (median). Adverse events reported were predictable and limited.
In a clinical setting, comparable improvement in BCVA and CRT were observed after DEX and IVR injections for treatment of BRVO. CRVO patients showed greater benefit with IVR.
KeywordsDexamethasone Ranibizumab Branch retinal vein occlusion Central retinal vein occlusion Macular edema Real-world data
We thank Dr. Patricia Buchholz for her advice.
Compliance with ethical standards
For this type of study, formal consent is not required.
Informed consent was obtained from all individual participants included in the study.
Conflict of interest
All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers’ bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements) or non-financial interest (such as personal or professional relationships, affiliations, knowledge or beliefs) in the subject matter or materials discussed in this manuscript.
- 1.Haller JA, Bandello F, Belfort R, Blumenkranz MS, Gillies M, Heier J, Loewenstein A, Yoon YH, Jarques ML, Jiao J, Li XY, Whitcup SM, OZURDEX GENEVA Study Group (2010) Randomized, sham- controlled trial of dexamethasone intravitreal implant in patients with macular edema due to retinal vein occlusion. Ophthalmology 117:1134–1146CrossRefPubMedGoogle Scholar
- 7.Augustin AJ, Holz FG, Haritoglou C, Mayer WJ, Bopp S, Scheuerle AF, Maier M, Sekundo W, Sandner D, Shirlaw A, Hattenbach LO (2015) Retrospective, observational study in patients receiving a dexamethasone intravitreal implant 0.7mg for macular oedema secondary to retinal vein occlusion. Ophthalmologica 233:18–26. https://doi.org/10.1159/000368840 CrossRefPubMedGoogle Scholar
- 8.Hattenbach LO, Feltgen N, Bertelmann T et al (2017) Head-to-head comparison of ranibizumab PRN versus single-dose dexamethasone for branch retinal vein occlusion (COMRADE-B). Acta Ophthalmol. https://doi.org/10.1111/aos.13381
- 9.Hoerauf H, Feltgen N, Weiss C, Paulus EM, Schmitz-Valckenberg S, Pielen A, Puri P, Berk H, Eter N, Wiedemann P, Lang GE, Rehak M, Wolf A, Bertelmann T, Hattenbach LO, COMRADE-C Study Group (2016) Clinical efficacy and safety of Ranibizumab versus Dexamethasone for central retinal vein occlusion (COMRADE C): a European label study. Am J Opthamol. https://doi.org/10.1016/j.ajo.2016.06.016
- 20.Korobelnik JF, Kodjikian L, Delcour C et al (2016) Two-year, prospective, multicentre study of the use of dexamethasone intravitreal implant for treatment of macular edema secondary to retinal vein occlusion in the clinical setting in France. Graefes Arch Clin Exp Ophthalmol 254(12):2307–2318CrossRefPubMedPubMedCentralGoogle Scholar
- 24.Narayanan R, Panchal B, Das T et al (2015) A randomised, double-masked, controlled study of the efficacy and safety of intravitreal bevacizumab versus ranibizumab in the treatment of macular oedema due to branch retinal vein occlusion: MARVEL report no.1. Br J Ophthalmol 99(7):954–959CrossRefPubMedGoogle Scholar