The effects of intravitreally injected dexamethasone implant and anti-VEGF on macular edema due to retinal vein occlusion

Aim: In this study, we aimed to investigate the efficacy of intravitreal treatment modalities for macular edema secondary to central retinal vein occlusion (CRVO) and branchial retinal vein occlusion (BRVO). Material and Methods: A total 58 patients with macular edema secondary to CRVO and BRVO were included in this retrospective study. The patients followed up between 2012 and 2018 were subjected to either intravitreal dexamethasone (DEX) implant injection (Group 1), or intravitreal anti-vascular endothelial growth factor (anti-VEGF) containing ranibizumab injection (Group 2). Additionally, the patients who received the combination of intravitreal DEX and anti-VEGF treatment (Group 3) were also assessed in this study. The degree of central macular thickness (CMT) using optical coherence tomography, and best -corrected visual acuity (BCVA) levels were evaluated in all groups before and after treatment. Results: CRVO and BRVO were present in 12 and 46 patients, respectively, and the mean follow- up time was 38 months. The mean CMT values measured in pretreatment vs. posttreatment period in Group 1, Group 2 and Group 3 were 448±41.3μm vs.217.7±15.9μm (p<0.05), 492±38.5μm vs.249.3±13.8μm (p<0.05), and 562.5±85.7μm vs.330.3±55.9μm (p<0.05), respectively. Regarding the comparison of BCVA levels measured in the pretreatment vs. postreatment period, there was a statistically significant increase in all groups as follows: 0.8±0.08 logMAR vs. 0.4±0.08 logMAR (p<0.05) in Group 1, 0.9±0.1 logMAR vs. 0.3±0.05 logMAR ( p<0.05) in Group 2, and 1.6±0.3 logMAR vs. 0.5±0.1 logMAR( p<0.05) in Group 3.Discussion: The intravitreal injection treatments with either dexamethasone implant or anti-VEGFs can have a potential effects on the resolution of macular edema secondary to BRVO. Moreover, their combination can be beneficial for the persistent macular edema arising from CRVO.