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Intravitreal dexamethasone implant versus anti-VEGF injection for treatment-naïve patients with retinal vein occlusion and macular edema: a 12-month follow-up study

Graefe's Archive for Clinical and Experimental Ophthalmology volume 253, pages 2095–2102 (2015)Cite this article

Abstract

Purpose

The objective of his study was to compare the visual and anatomical outcomes in treatment-naïve patients with macular edema secondary to retinal vein occlusion after intravitreal injections of dexamethasone implants (DEX) and anti-VEGF.

Methods

One hundred two patients (64 in the anti-VEGF group, 38 in the DEX group) without previous treatment were included in this multi-center retrospective study and evaluated at baseline and 1, 3, 6, and 12 months after the onset of treatment. Patients were defined as "good responders" if central macular thickness (CMT) was less than or equal to 250 μm in TD-OCT or 300 μm in SD-OCT after the injections.

Results

At month 3 (n = 102), BCVA had increased significantly, by 0.1 ± 0.3 logMAR in the anti-VEGF group (p = 0.04) and 0.4 ± 0.4 logMAR in the DEX group (p < 0.001); the difference between the two groups was statistically significant (p = 0.007). CMT decreased significantly, by 138 ± 201 μm (−19 %, p < 0.001) in the anti-VEGF group and 163 ± 243 μm (−21 %, p < 0.001) in the DEX group. After 3 months, five patients (13 %) in the DEX group and 20 (31 %) in the anti-VEGF group (p < 0.001) changed treatment. Among the 77 patients who did not switch from their initial treatment, no significant functional or anatomical difference between the two groups was observed at months 6 and 12. Elevation of intraocular pressure > 21 mmHg was more frequent in the DEX group (21 %) than in the anti-VEGF group (3 %, p = 0.008).

Conclusions

Visual acuity recovery was better in the DEX group than in the anti-VEGF group at month 3, but with no difference in CMT. In patients who did not change treatment, the long-term anatomical and visual outcome was similar between the DEX and anti-VEGF groups.

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Acknowledgments

The authors maintain full control of all primary data, and have agreed to allow Graefes Archive for Clinical and Experimental Ophthalmology to review their data upon request. The authors have no financial interests in any device or drug mentioned in this study.

Grants

Financial support was provided by the Association for Research and Education in Ophthalmology (ARFO).

Author information

Affiliations

  1. Department of Ophthalmology, University Hospital, Grenoble, France

    C. Chiquet, C. Dupuy, F. Aptel & J. P. Romanet

  2. Grenoble Alpes University, Grenoble, 38041, France

    C. Chiquet, C. Dupuy, F. Aptel & J. P. Romanet

  3. Department of Ophthalmology, University Hospital, Dijon, France

    A. M. Bron, M. Straub, R. Isaico & C. Creuzot-Garcher

  4. Eye and Nutrition Research Group, CSGA, UMR1324 INRA, 6265 CNRS, Université de Bourgogne, Dijon, France

    A. M. Bron & C. Creuzot-Garcher

  5. Clinique Universitaire d’Ophtalmologie, CHU de Grenoble – University Hospital of Grenoble, 38043, Grenoble, Cedex 09, France

    C. Chiquet

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  1. C. Chiquet
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  2. C. Dupuy
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Chiquet, C., Dupuy, C., Bron, A.M. et al. Intravitreal dexamethasone implant versus anti-VEGF injection for treatment-naïve patients with retinal vein occlusion and macular edema: a 12-month follow-up study. Graefes Arch Clin Exp Ophthalmol 253, 2095–2102 (2015). https://doi.org/10.1007/s00417-015-2947-9

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  • DOI: https://doi.org/10.1007/s00417-015-2947-9

Keywords

  • Dexamethasone implant
  • Anti-VEGF
  • Ranibizumab
  • Bevacizumab
  • Retinal vein occlusion
  • Macular edema