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

Abstract

To evaluate the effectiveness of in travitreal bevacizumab injections following a single dexametha sone implant in the treatment of macular edema secondary to branch and central retinal vein occlusion. Methods: This was a prospective interventional noncomparative 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 followedup at fourweek 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 asneeded basis. The outcome measures were bestcorrected visual acuity and central macular thickness changes. Results: The mean bestcorrected visual acuity changed from 0.97 ± 0.33 LogMAR at baseline to 0.54 ± 0.40 at the sixmonth postimplant 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 sixmonth followup (p<0.00001). The mean number of intravitreal bevacizumab injections received in the six months postimplant was 2.32. The mean time from dexamethasone implant to first antiVEGF injection was 3.45 months. Conclusions: Intravitreal bevacizumab injections following a single dexamethasone implant were found to improve bestcorrected 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.