Clinical Use of Dexamethasone Implants in Resistant Macular Edema Secondary to Branch Retinal Vascular Occlusion Compared with Intravitreal Anti-Vascular Endothelial Growth Factor

Objectives: Branch retinal vein occlusion (BRVO) is the second most common type of retinal vascular disorder. Both inflammation and increased vascular endothelial growth factor (VEGF) levels play important roles in the pathogenesis of macular edema (ME) secondary to BRVO. The aim of this study was to compare the efficacy of 0.7-mg intravitreal dexamethasone implants with continued anti-VEGF treatment in patients with ME secondary to BRVO who were poor responders to at least 6 previous anti-VEGF injections. Methods: Patients exhibiting an insufficient response to at least 6 ranibizumab treatments and who subsequently under-went a dexamethasone implant were included Group 1. Patients who were at risk for cataract or glaucoma continued treatment with the same drug and were defined as Group 2. The best corrected visual acuity (BCVA) and central macular thickness (CMT) changes at month 2, 4, and 6 were measured. Results: Ninety eyes were evaluated. In Group 1, the mean baseline BCVA of 0.71±0.75 logarithm of the minimum angle of resolution (logMAR) improved to 0.53±0.62 logMAR at month 2 (p

Kaynakça

Stefánsson E. The therapeutic effects of retinal laser treatment and vitrectomy. A theory based on oxygen and vascular physi-ology. Acta Ophthalmol Scand 2001;79:435–40.

Arnarsson A, Stefánsson E. Laser treatment and the mecha-nism of edema reduction in branch retinal vein occlusion. Invest Ophthalmol Vis Sci 2000;41:877–9.

Silva RM, Faria de Abreu JR, Cunha-Vaz JG. Blood-retina barrier in acute retinal branch vein occlusion. Graefes Arch Clin Exp Ophthalmol 1995;233:721–6.

Saika S, Tanaka T, Miyamoto T, Ohnishi Y. Surgical posterior vitreous detachment combined with gas/air tamponade for treating macular edema associated with branch retinal vein oc-clusion: retinal tomography and visual outcome. Graefes Arch Clin Exp Ophthalmol 2001;239:729–32.

Aiello LP, Avery RL, Arrigg PG, Keyt BA, Jampel HD, Shah ST, et al. Vascular endothelial growth factor in ocular fluid of patients with diabetic retinopathy and other retinal disorders. N Engl J Med 1994;331:1480–7.

Noma H, Minamoto A, Funatsu H, Tsukamoto H, Nakano K, Yamashita H, et al. Intravitreal levels of vascular endothelial growth factor and interleukin-6 are correlated with macular edema in branch retinal vein occlusion. Graefes Arch Clin Exp Ophthalmol 2006;244:309–15.

Rogers SL, McIntosh RL, Lim L, Mitchell P, Cheung N, Kowal-ski JW, et al. Natural history of branch retinal vein occlu-sion: an evidence-based systematic review. Ophthalmology 2010;117:1094–1101.e5.

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;117:1113–1123.e15.

Pielen A, Bühler AD, Heinzelmann SU, Böhringer D, Ness T, Junker B. Switch of Intravitreal Therapy for Macular Edema Secondary to Retinal Vein Occlusion from Anti-VEGF to Dexamethasone Implant and Vice Versa. J Ophthalmol 2017;2017:5831682.

Lee KH, Kang EC, Koh HJ. Dexamethasone Intravitreal Implant Rescue Treatment for Bevacizumab Refractory Macular Edema Secondary to Branch Retinal Vein Occlusion. Korean J Ophthal-mol 2017;31:108–114.

Campochiaro PA, Heier JS, Feiner L, Gray S, Saroj N, Rundle AC, et al. Ranibizumab for macular edema following branch retinal vein occlusion: six-month primary end point results of a phase III study. Ophthalmology 2010;117:1102–1112.e1.

Brown DM, Campochiaro PA, Singh RP, Li Z, Gray S, Saroj N, et al. Ranibizumab for macular edema following central retinal vein occlusion: six-month primary end point results of a phase III study. Ophthalmology 2010;117:1124–1133.e1.

Varma R, Bressler NM, Suñer I, Lee P, Dolan CM, Ward J, et al. Improved vision-related function after ranibizumab for macular edema after retinal vein occlusion: results from the BRAVO and CRUISE trials. Ophthalmology 2012;119:2108–18.

Ramezani A, Esfandiari H, Entezari M, Moradian S, Soheilian M, Dehsarvi B, et al. Three intravitreal bevacizumab versus two intravitreal triamcinolone injections in recent onset central retinal vein occlusion. Acta Ophthalmol 2014;92:e530–9.

Tagami M, Sai R, Fukuda M, Azumi A. Prolongation of injection interval after switching therapy from ranibizumab to aflibercept in Japanese patients with macular edema secondary to branch retinal vein occlusion. Clin Ophthalmol 2017;11:403–408.

Hanhart J, Rozenman Y. Comparison of Intravitreal Ranibizumab, Aflibercept, and Dexamethasone Implant after Bevacizumab Failure in Macular Edema Secondary to Retinal Vascular Occlu-sions. Ophthalmologica 2017;238:110–118.

Chiquet C, Dupuy C, Bron AM, Aptel F, Straub M, Isaico R, et al. Intravitreal dexamethasone implant versus anti-VEGF in-jection for treatment-naïve patients with retinal vein occlusion and macular edema: a 12-month follow-up study. Graefes Arch Clin Exp Ophthalmol 2015;253:2095–102.

Alshahrani ST, Dolz-Marco R, Gallego-Pinazo R, Diaz-Llopis M, Arevalo JF; KKESH International Collaborative Retina Study Group. Intravitreal Dexamethasone Implant For The Treatment Of Refractory Macular Edema In Retinal Vascular Diseases: Re-sults Of The Kkesh International Collaborative Retina Study Group. Retina 2016;36:131–6.

Reid GA, Sahota DS, Sarhan M. Observed Complications From Dexamethasone Intravitreal Implant For The Treatment Of Macular Edema In Retinal Vein Occlusion Over 3 Treatment Rounds. Retina 2015;35:1647–55.

Capone A Jr, Singer MA, Dodwell DG, Dreyer RF, Oh KT, Roth DB, et al. Efficacy and safety of two or more dexametha-sone intravitreal implant injections for treatment of macular edema related to retinal vein occlusion (Shasta study). Retina 2014;34:342–51.

Eter N, Mohr A, Wachtlin J, Feltgen N, Shirlaw A, Leaback R; German Ozurdex in RVO Real World Study Group. Dexam-ethasone intravitreal implant in retinal vein occlusion: real-life data from a prospective, multicenter clinical trial. Graefes Arch Clin Exp Ophthalmol 2017;255:77–87.

Haller JA, Bandello F, Belfort R Jr, Blumenkranz MS, Gillies M, Heier J, et al. Dexamethasone intravitreal implant in patients with macular edema related to branch or central reti-nal vein occlusion twelve-month study results. Ophthalmology 2011;118:2453–60.

Wessel MM, D’Amico DJ, Kiss S. Multiple Treatments of the Sustained-Release Dexamethasone Implant in Retinal Vein Oc-clusion. IOVS 2012;53:2243.

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