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KMID : 1151620200050020135
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Journal of Retina
2020 Volume.5 No. 2 p.135 ~ p.142
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Comparison of Intravitreal Dexamethasone Implant and Bevacizumab Injection for Branch Retinal Vein Occlusion with Macular Edema According to Macular Perfusion
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Lee Seung-Joon
Choi Chang-Wook
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Abstract
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Purpose: To compare the difference of efficacy between intravitreal dexamethasone implant and bevacizumab injection for patients with branch retinal vein occlusion (BRVO) with macular edema (ME) according to macular perfusion status.
Methods: This study comprised 104 eyes of 104 patients who were first diagnosed with BRVO with ME and were able to be observed for more than 6 months and retrospectively analyzed. Based on the results from fluorescein angiography, the patients were classified into either non-perfusion or perfusion type according to macular perfusion status, and treatment with either an intravitreal dexamethasone implant or bevacizumab injection was performed. If the patient experienced a relapse after the first bevacizumab injection, the treatment was replaced with dexamethasone implant, or retreatment was performed with bevacizumab. Changes in best-corrected visual acuity (BCVA) and central macular thickness (CMT) before treatment and at 6 months after treatment were analyzed in each treatment group.
Results: In the non-perfusion type, all treatment methods resulted in significant changes in BCVA and CMT; in the perfusion type, there was a significant change in CMT. Post-hoc analysis regarding the changes in BCVA and CMT demonstrated a significant difference in the changes of BCVA and CMT between the dexamethasone implant group and the bevacizumab injection group in patients in the non-perfusion type (p = 0.028, p = 0.008, respectively), and there was a significant difference in change of BCVA between the group that replaced bevacizumab with dexamethasone implant and the group that reinjected bevacizumab (p = 0.005).
Conclusions: Treatment with either intravitreal dexamethasone implant or bevacizumab injection was effective in patients with ME due to BRVO, regardless of macular perfusion status. Treatment with intravitreal dexamethasone implant in patients with non-perfusion type ME due to BRVO may have better functional and anatomical results than bevacizumab injection.
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KEYWORD
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Bevacizumab, Branch retinal vein occlusion, Dexamethasone implant, Macular edema, Macular perfusion
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