Abstract
Purpose :
To compare the anatomical and functional outcomes of switching from anti-VEGF agents to intravitreal dexamethasone implant after three or six consecutive monthly injections in patients with retinal vein occlusion (RVO) and poor response to anti-VEGF treatment.
Methods :
Patients with treatment-naïve RVO, who showed a poor anatomical response to three or six consecutive intravitreal anti-VEGF injections and received intravitreal dexamethasone implant were enrolled in this prospective study. Patients were divided into two groups as early- (3 injections) and late- (6 injections) switch groups. Best corrected visual acuity (BCVA) and central retinal thickness (CRT) at baseline and at months 3, 6, 9, 12 and 18 were recorded, while the baseline characteristics of patients were also analyzed.
Results :
35 eyes of 35 patients were included in the study. The early-switch group consisted of 17 eyes and the late-switch group consisted of 18 eyes. The mean change in BCVA and CRT did not differ significantly between the two groups at the end of the follow-up period of 18 months compared to baseline (p=0.092 and p=0.201 for BCVA and CRT respectively), although at month 6 the early-switch group presented greater anatomical improvement (p=0.023). Baseline characteristics, which could affect the treatment response and suggest early switch were the presence of hyperreflective foci, the reflectivity and height of intraretinal cysts, the higher CRT and the baseline BCVA.
Conclusions :
Although both early- switching and late- switching to intravitreal dexamethasone implant had similar functional outcomes in patients with RVO and poor response to initial anti-VEGF treatment, specific baseline characteristics may suggest early switch to improve better anatomical and functional treatment response, in the context of individualized approach.
This is a 2020 ARVO Annual Meeting abstract.