Comparison of intravitreal bevacizumab and dexamethasone implant for the treatment of macula oedema associated with branch retinal vein occlusion

Abstract

BACKGROUND/AIMS: To compare the functional and anatomical outcomes of intravitreal bevacizumab (IVB) with those of dexamethasone implant injection (IVD) for macular oedema associated with branch retinal vein occlusion (BRVO).

METHODS: Seventy-two patients with centre-involving macular oedema secondary to BRVO were retrospectively enrolled in the study; these patients were treated with either 1.25 mg IVB (44 eyes; mean injections: 2.92±1.38) pro re nata (PRN) by follow-up monthly or 700 µg IVD (28 eyes; mean injections: 1.71±0.47) given at 6-month intervals PRN and were followed for at least 12 months. Main outcome measures were changes in best-corrected visual acuity (BCVA) and central foveal thickness (CFT).

RESULTS: There was no statistically significant difference of mean change of the logarithm of the minimum angle of resolution BCVA between IVB and IVD groups at monthly visits, up to 12 months (all p>0.05); however, there was a trend towards greater BCVA gain in the IVB group than in the IVD group at 6 months (p=0.053). Additionally, 52.6% in the IVB group and 50% in the IVD group gained two or more lines of Snellen visual acuity at 12 months (p=0.85). The mean CFT decreased by 160 µm for the IVB group and by 140.7 µm for the IVD group at 12 months. Both the IVB group and the IVD group achieved statistically similar improvement of CFT at monthly visits, up to 5 months (all p>0.05); however, the CFT began to deteriorate after 5 months in the IVD group, and at 6 months, improvement in the IVB group was significantly greater than that in the IVD group (p=0.007). After a second IVD injection at 6 months, the IVD group showed significant improvement of CFT, and there was no significant difference of CFT change between the IVB and IVD groups until 12 months.

CONCLUSIONS: For macular oedema secondary to BRVO, IVB administered PRN monthly and IVD administered PRN at 6-month intervals, yielded functionally and anatomically comparable outcomes at 12 months.