J Korean Ophthalmol Soc.  2020 Nov;61(11):1279-1287. 10.3341/jkos.2020.61.11.1279.

Two-dimensional Quantitative Effects of Anti-vascular Endothelial Growth Factor and Dexamethasone Implants on Retinal Vein Occlusion

• Jang M
• Lee H
• Kim HC
• Chung H

• KMID: 2511265
• DOI: http://doi.org/10.3341/jkos.2020.61.11.1279

Abstract

Purpose
We quantitatively analyzed the therapeutic effects of intravitreal anti-vascular endothelial growth factor (anti-VEGF) and dexamethasone implants used to treat macular edema caused by retinal vein occlusion.
Methods
Eighty-three patients with branch retinal vein occlusion (BRVO) or central retinal vein occlusion (CRVO) with macular edema treated from February 2009 to August 2019 via anti-VEGF injections or dexamethasone implants were enrolled. The medical records of 83 eyes were retrospectively analyzed. Horizontal B-scan spectral domain optical coherence tomography images spanning the foveal center were obtained before treatment and 1 month later. These were analyzed with the aid of Image J software and the numbers of pixels corresponding to intraretinal and subretinal fluids calculated.
Results
In patients with BRVO, the retinal fluid changes were identical 1 month after injection in both the anti-VEGF injection and the dexamethasone implant groups. For CRVO cases, the dexamethasone implant group exhibited a significantly higher loss of retinal fluid and thus a greater reduction in retinal edema than the anti-VEGF group. Linear regression analysis revealed that in BRVO cases poor final visual acuity was associated with a large amount of fluid at baseline and poor visual acuity 1 and 3 months after treatment. In CRVO cases, poor final visual acuity was associated with a large change in the intraretinal fluid level and poor visual acuity 3 months after treatment.
Conclusions
The extent of anatomical and visual acuity improvement did not differ between the anti-VEGF injection and the dexamethasone injection groups with BRVO. For CRVO patients, the short-term anatomical improvement was significantly greater in the latter group, but the extent of vision improvement was significantly higher in the former group.

Keyword

Anti-vascular endothelial growth factor; Branch retinal vein occlusion; Central retinal vein occlusion; Dexamethasone implant