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Zoya Hameed, Dibah Jivah, Umair Janjua, Gulrez Ansari, Manju Chandran, Geeta Menon; Treatment of retinal vein occlusions: intravitreal dexamethasone implant versus intravitreal bevacizumab 12 months outcomes. Invest. Ophthalmol. Vis. Sci. 2014;55(13):3868.
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To compare the visual outcomes and change in central macular thickness (CMT) over 12 months of patients with macular edema (ME) secondary to branch and central retinal vein occlusion (BRVO and CRVO respectively) treated with intravitreal dexamethasone implants (IVO, Ozurdex, Allergan) or intravitreal bevacizumab (IVB, Avastin, Genentech/Roche).
We performed a retrospective case review of patients who were treated with either IVO or IVB for ME secondary to BRVO and CRVO. The main outcomes measured in this study were best corrected visual acuity (BCVA) and CMT. In both groups patient data was recorded from an initial pre-treatment visit (month 0) and then at months 3, 6, 9, and 12. All patients had a minimum 1-year follow up. Results between the two treatment groups were compared to establish the change in BCVA and CMT between month 0 and month 12. Statistical analysis was carried out using the paired Student’s t-test for changes in VA and the Wilcoxon signed-rank test for changes in CMT. All statistical analysis was carried out using IBM SPSS Statistics v22.0 (2013).
The IVO group included 23 patients (16 BRVO and 7 CRVO). 10 were treatment naive, while the 13 had previously received IVB, macular grid laser, or both. The IVB group included 20 patients (12 BRVO and 8 CRVO). 8 were treatment naïve while 12 had previously received intravitreal triamcinolone, macular grid laser or both. The mean baseline BCVA in the IVO group was 55.13 letters and in the IVB group 52.3 letters. The mean change in BCVA over 12 months was -0.04 letters and +9.5 letters in the IVO and IVB groups respectively. There was a statistically significant change in the BCVA over 12 months in the IVB group only (p≤ 0.001). The mean baseline CMT was 462.57 (IVO) and 432.45 (IVB). The mean change in CMT over 12 months was -89.57μ and -97.3μ in the IVO and IVB groups respectively. There was a statistically significant change in the CMT over 12 months in both groups with p≤ 0.016 (IVO) and p≤ 0.021 (IVB). At 12 months there was no significant difference in the change in BCVA and CMT between the two treatment modalities. There were no complications recorded in this sample.
In our series IVB was superior to IVO for visual improvement. CMT reduction was more significant in IVO than IVB, though no significant difference existed between the two groups in final measured outcomes.
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