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. 2023 May-Jun;86(3):255-262.
doi: 10.5935/0004-2749.20230040.

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

María Moreno-López  1 , Pablo de-Arriba-Palomero  1 , Fernando de-Arriba-Palomero  1 , Federico Peralta Ituruburu  1 , Elisabet de Dompablo  1 , Francisco José Muñoz- Negrete  1
Affiliations

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

María Moreno-López et al. Arq Bras Oftalmol. 2023 May-Jun.

Abstract
in English, Portuguese

Purpose: To evaluate the effectiveness of in---travitreal bevacizumab injections following a single dexamethasone implant in the treatment of macular edema secondary to branch and central retinal vein occlusion.

Methods: This was a prospective interventional non-comparative 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 followed-up at four-week 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 as-needed basis. The outcome measures were best-corrected visual acuity and central macular thickness changes.

Results: The mean best-corrected visual acuity changed from 0.97 ± 0.33 LogMAR at baseline to 0.54 ± 0.40 at the six-month post-implant 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 six-month follow-up (p<0.00001). The mean number of intravitreal bevacizumab injections received in the six months post-implant was 2.32. The mean time from dexamethasone implant to first anti-VEGF injection was 3.45 months.

Conclusions: Intravitreal bevacizumab injections following a single dexamethasone implant were found to improve best-corrected 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.

Objetivo: Avaliar a eficácia da combinação de injeções intravítreas de bevacizumabe em olhos com edema macular secundário à oclusão de ramo e da veia central da retina após um único implante de dexametasona.

Métodos: Foi realizado um estudo prospectivo intervencionista não comparativo com 44 olhos de pacientes com edema macular relacionado à oclusão de ramo e veia central da retina, sem tratamento prévio e tratados com um único implante de dexametasona, que foram acompanhados em intervalos de quatro semanas do segundo ao sexto mês. Se fosse constatado edema macular persistente ou recorrente durante esse período, os pacientes eram tratados com injeções intravítreas de bevacizumabe em um regime ajustado conforme a necessidade. Foram estudadas a melhor acuidade visual corrigida e alterações da espessura macular central.

Resultados: A média da melhor acuidade visual corrigida mudou de 0,97 ± 0,33 LogMAR iniciais para 0,54 ± 0,40 no exame de 6 meses (p<0,00001). Vinte olhos (45,54%) melhoraram 3 linhas de Snellen ou mais. A média da espessura macular central inicial foi de 670,25 ± 209,9 µm e diminuiu para 317,43 ± 112,68 µm na visita de 6 meses (p<0,00001). O número médio de injeções intravítreas de bevacizumabe em 6 meses foi de 2,32 e o tempo médio entre o implante de dexametasona e a primeira injeção de anti-VEGF foi de 3,45 meses.

Conclusão: Injeções intravítreas de bevacizumabe após um único implante de dexametasona podem proporcionar um aumento da melhor acuidade visual corrigida e diminuição da espessura macular central aos 6 meses em pacientes com edema macular devido à oclusão de ramo e da veia central da retina, com poucas injeções intravítreas.

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Conflict of interest statement

Disclosure of potential conflicts of interest: None of the authors have any potential conflicts of interest to disclose.

Figures

Figure 1
Figure 1
The number of intravitreal bevacizumab (IVB) reinjections required following a single dexamethasone implant in the treatment of macular edema secondary to retinal vein occlusion.
Figure 2
Figure 2
Months after dexamethasone implant when first intravitreal bevacizumab (IVB) injection was required in patients with macular edema secondary to retinal vein occlusion.
See this image and copyright information in PMC

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References

    1. Ip M, Hendrick A. Retinal vein occlusion review. Asia-Pacific J Ophthalmol. 2018;7(1):40–5. - PubMed
    1. McIntosh RL, Rogers SL, Lim L, Cheung N, Wang JJ, Mitchell P, et al. Natural history of central retinal vein occlusion: an evidence-based systematic review. Ophthalmology. 2010;117(6):1113–23.e15. - PubMed
    1. Rogers S, McIntosh RL, Cheung N, Lim L, Wang JJ, Mitchell P, et al. The prevalence of retinal vein occlusion: pooled data from population studies from the United States, Europe, Asia, and Australia. Ophthalmology. 2010;117(2):313.e1–319.e1. - PMC - PubMed
    1. Brown DM, Campochiaro PA, Singh RP, Li Z, Gray S, Saroj N, Rundle AC, Rubio RG, Murahashi WY, CRUISE Ranibizumab for macular edema following central retinal vein occlusion. six-month primary end point results of a phase III study. Ophthalmology. 2010;117(6):1124.e1–1133.e1. Comment in: Ophthalmology. 2010; 117(6): 1061-3. - PubMed
    1. Campochiaro PA, Heier JS, Feiner L, Gray S, Saroj N, Rundle AC, Murahashi WY, Rubio RG, BRAVO Investigators Ranibizumab for macular edema following branch retinal vein occlusion. six-month primary end point results of a phase III study. Ophthalmology. 2010;117(6):1102.e1–1112.e1. - PubMed

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