Switch of Intravitreal Therapy for Macular Edema Secondary to Retinal Vein Occlusion from Anti-VEGF to Dexamethasone Implant and Vice Versa
Purpose. To evaluate the anatomical and functional outcome of intravitreal dexamethasone implant for macular edema secondary to central (C) or branch (B) retinal vein occlusion (RVO) in patients with persistent macular edema (ME) refractory to intravitreal antivascular endothelial growth factor (VEG...
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| Format: | Article |
| Language: | English |
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Wiley
2017-01-01
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| Series: | Journal of Ophthalmology |
| Online Access: | http://dx.doi.org/10.1155/2017/5831682 |
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| author | Amelie Pielen Anima Desiree Bühler Sonja Ute Heinzelmann Daniel Böhringer Thomas Ness Bernd Junker |
| author_facet | Amelie Pielen Anima Desiree Bühler Sonja Ute Heinzelmann Daniel Böhringer Thomas Ness Bernd Junker |
| author_sort | Amelie Pielen |
| collection | DOAJ |
| description | Purpose. To evaluate the anatomical and functional outcome of intravitreal dexamethasone implant for macular edema secondary to central (C) or branch (B) retinal vein occlusion (RVO) in patients with persistent macular edema (ME) refractory to intravitreal antivascular endothelial growth factor (VEGF) treatment compared to treatment naïve patients and to dexamethasone-refractory eyes switched to anti-VEGF. Methods. Retrospective, observational study including 30 eyes previously treated with anti-VEGF (8 CRVO, 22 BRVO, mean age 69 ± 10 yrs), compared to 11 treatment naïve eyes (6 CRVO, 5 BRVO, 73 ± 11 yrs) and compared to dexamethasone nonresponders (2 CRVO, 4 BRVO, 69 ± 12). Outcome parameters were change in best-corrected visual acuity (BCVA) and central foveal thickness (CFT) measured by spectral-domain optical coherence tomography. Results. Mean BCVA improvement after switch to dexamethasone implant was 4 letters (p=0.08), and treatment naïve eyes gained 10 letters (p=0.66), while we noted no change in eyes after switch to anti-VEGF (p=0.74). Median CFT decrease was most pronounced in treatment naïve patients (−437 μm, p=0.002) compared to anti-VEGF refractory eyes (−170 μm, p=0.003) and dexamethasone-refractory eyes (−157, p=0.31). Conclusions. Dexamethasone significantly reduced ME secondary to RVO refractory to anti-VEGF. Functional gain was limited compared to treatment naïve eyes, probably due to worse BCVA and CFT at baseline in treatment naïve eyes. |
| format | Article |
| id | doaj-art-ba3e7815760a48589a0d86b19055b0ef |
| institution | Kabale University |
| issn | 2090-004X 2090-0058 |
| language | English |
| publishDate | 2017-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of Ophthalmology |
| spelling | doaj-art-ba3e7815760a48589a0d86b19055b0ef2025-02-03T05:50:08ZengWileyJournal of Ophthalmology2090-004X2090-00582017-01-01201710.1155/2017/58316825831682Switch of Intravitreal Therapy for Macular Edema Secondary to Retinal Vein Occlusion from Anti-VEGF to Dexamethasone Implant and Vice VersaAmelie Pielen0Anima Desiree Bühler1Sonja Ute Heinzelmann2Daniel Böhringer3Thomas Ness4Bernd Junker5University Eye Hospital, Hanover Medical School, Hanover, GermanyUniversity Eye Hospital, Hanover Medical School, Hanover, GermanyEye Center, University Hospital Freiburg, Freiburg, GermanyEye Center, University Hospital Freiburg, Freiburg, GermanyEye Center, University Hospital Freiburg, Freiburg, GermanyUniversity Eye Hospital, Hanover Medical School, Hanover, GermanyPurpose. To evaluate the anatomical and functional outcome of intravitreal dexamethasone implant for macular edema secondary to central (C) or branch (B) retinal vein occlusion (RVO) in patients with persistent macular edema (ME) refractory to intravitreal antivascular endothelial growth factor (VEGF) treatment compared to treatment naïve patients and to dexamethasone-refractory eyes switched to anti-VEGF. Methods. Retrospective, observational study including 30 eyes previously treated with anti-VEGF (8 CRVO, 22 BRVO, mean age 69 ± 10 yrs), compared to 11 treatment naïve eyes (6 CRVO, 5 BRVO, 73 ± 11 yrs) and compared to dexamethasone nonresponders (2 CRVO, 4 BRVO, 69 ± 12). Outcome parameters were change in best-corrected visual acuity (BCVA) and central foveal thickness (CFT) measured by spectral-domain optical coherence tomography. Results. Mean BCVA improvement after switch to dexamethasone implant was 4 letters (p=0.08), and treatment naïve eyes gained 10 letters (p=0.66), while we noted no change in eyes after switch to anti-VEGF (p=0.74). Median CFT decrease was most pronounced in treatment naïve patients (−437 μm, p=0.002) compared to anti-VEGF refractory eyes (−170 μm, p=0.003) and dexamethasone-refractory eyes (−157, p=0.31). Conclusions. Dexamethasone significantly reduced ME secondary to RVO refractory to anti-VEGF. Functional gain was limited compared to treatment naïve eyes, probably due to worse BCVA and CFT at baseline in treatment naïve eyes.http://dx.doi.org/10.1155/2017/5831682 |
| spellingShingle | Amelie Pielen Anima Desiree Bühler Sonja Ute Heinzelmann Daniel Böhringer Thomas Ness Bernd Junker Switch of Intravitreal Therapy for Macular Edema Secondary to Retinal Vein Occlusion from Anti-VEGF to Dexamethasone Implant and Vice Versa Journal of Ophthalmology |
| title | Switch of Intravitreal Therapy for Macular Edema Secondary to Retinal Vein Occlusion from Anti-VEGF to Dexamethasone Implant and Vice Versa |
| title_full | Switch of Intravitreal Therapy for Macular Edema Secondary to Retinal Vein Occlusion from Anti-VEGF to Dexamethasone Implant and Vice Versa |
| title_fullStr | Switch of Intravitreal Therapy for Macular Edema Secondary to Retinal Vein Occlusion from Anti-VEGF to Dexamethasone Implant and Vice Versa |
| title_full_unstemmed | Switch of Intravitreal Therapy for Macular Edema Secondary to Retinal Vein Occlusion from Anti-VEGF to Dexamethasone Implant and Vice Versa |
| title_short | Switch of Intravitreal Therapy for Macular Edema Secondary to Retinal Vein Occlusion from Anti-VEGF to Dexamethasone Implant and Vice Versa |
| title_sort | switch of intravitreal therapy for macular edema secondary to retinal vein occlusion from anti vegf to dexamethasone implant and vice versa |
| url | http://dx.doi.org/10.1155/2017/5831682 |
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