Title:Safety and Efficiency of Anti-VEGF with Dexamethasone Intravitreal Implant for Non-Ischemic Retinal Vein Occlusion: A Prospective, Case-controlled, Cohort Study
Volume: 19
Issue: 4
Author(s): Xiaohui Cai, Jing Zhao and Yalong Dang*
Affiliation:
- Department of Ophthalmology, Sanmenxia Eye Hospital/Sanmenxia Central Hospital Affiliated to Henan University
of Science and Technology, Sanmenxia, 472000, China
- Henan International Joint Laboratory of Outflow Engineering,
Sanmenxia Central Hospital, School of Medicine, Henan University of Science and Technology, Sanmenxia,
47200, China
Keywords:
Vascular endothelial growth factor, retinal vein occlusion, best corrected visual acuity, central macular thickness, adverse event, ranibizumab group.
Abstract:
Objective: This study aimed to assess the efficacy and safety of anti-VEGF combined
with dexamethasone implant for the retinal vein occlusion patients with macular edema.
Methods: In this prospective, case-controlled, cohort clinical trial (Register ID: ChiCTR2400080048),
patients with non-ischemic retinal vein occlusion were enrolled from the Sanmenxia
Central Hospital from August 2020 to April 2023. The patients were randomized into two
groups. All the patients received ranibizumab intravitreal injection in the first 3 consecutive
months. For the ranibizumab group, anti-VEGF injections were as needed thereafter in case of recurrence
of macular edema; For the combination group, the patients received an intravitreal dexamethasone
implant injection at 15 days after the first ranibizumab injection. The primary outcome
measurements were improvement in best corrected visual acuity (BCVA) and reduction in
central macular thickness (CMT). The secondary outcomes were recurrence of macular edema,
number of intravitreal injections, and injection interval. Safety profiles were also recorded.
Results: A total of 124 patients were included, of which 73 patients completed all follow-ups.
Both the ranibizumab monotherapy and the combination therapy significantly improved BCVA at
all time points, compared to the baseline. The combined group achieved more BCVA improvement
in 3 months, 6 months, and 12 months, compared to the ranibizumab alone group. Compared
to the baseline, both groups achieved significant reductions in CMT at all follow-ups. However,
the combination group showed more CMT reduction at 1 week post injection, compared to the
ranibizumab group. The combination group had a significantly longer injection interval, lower injection
time, and recurrence of macular edema. Ocular hypertension was the most common adverse
events. Lastly, intraocular pressure was all well controlled by 1-3 glaucoma medications
without surgical intervention.
Conclusion: The combination therapy could significantly improve the BCVA and reduce the
CMT with a good safety profile.
