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Comparison of intravitreal bevacizumab upload followed by a dexamethasone implant versus dexamethasone implant monotherapy for retinal vein occlusion with macular edema.
Ophthalmologica. 2012; 228(2):110-6.O

Abstract

PURPOSE

To compare the efficacy and safety of three intravitreal bevacizumab upload injections followed by a dexamethasone implant versus dexamethasone implant monotherapy in eyes with macular edema due to retinal vein occlusion.

METHODS

Sixty-four eyes of 64 patients were included in this prospective, consecutive, nonrandomized case series: group 1 consisted of 38 patients (22 with central retinal vein occlusion, CRVO, 16 with branch retinal vein occlusion, BRVO) treated using a dexamethasone implant (Ozurdex) alone; group 2 consisted of 26 patients (14 CRVO, 12 BRVO) treated with three consecutive intravitreal bevacizumab injections at monthly intervals followed by a dexamethasone implant. In case of recurrence, both cohorts received further dexamethasone implants. Preoperatively and monthly best corrected visual acuity (BCVA, ETDRS), central retinal thickness (Spectralis-OCT), intraocular pressure, and wide-angle fundus photodocumentation (Optomap) were performed. The primary clinical endpoint was BCVA at 6 months after initiation of therapy. Secondary endpoints were central retinal thickness and safety of the therapy applied.

RESULTS

In group 1, an increase in BCVA of 2.5 (±1.6) letters in the CRVO and of 13.0 (±3.2) letters in BRVO patients was seen after 6 months, in group 2 of 5.9 (±0.4) letters (CRVO) and 3.8 (±2.4) letters (BRVO), which was not statistically significant. When comparing the two treatment groups with respect to the type of vein occlusion, there was a significant advantage for BRVO patients for the dexamethasone implant monotherapy (BRVO patients in group 1, p = 0.005). Central retinal thickness showed a significant reduction after 6 months only in patients of group 1, both for CRVO (p = 0.01) and BRVO (p = 0.003). First recurrence after the first dexamethasone implant injection occurred after 3.8 months (mean) in CRVO and 3.5 months in BRVO patients (group 1), versus 3.2 and 3.7 months, respectively, in group 2. In group 1, 63.6% with CRVO and 50% with BRVO showed an increased intraocular pressure after treatment; in group 2, 57.1% with CRVO and 50.0% with BRVO, respectively.

CONCLUSION

In CRVO, there was no difference between the two treatment strategies investigated. However, in BRVO, dexamethasone implant monotherapy was associated with better functional outcome.

Authors+Show Affiliations

Department of Ophthalmology, Ludwig Maximilians University Munich, Mathildenstrasse 8, Munich, Germany. wolfgang.j.mayer @ med.uni-muenchen.deNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

22739239

Citation

Mayer, Wolfgang J., et al. "Comparison of Intravitreal Bevacizumab Upload Followed By a Dexamethasone Implant Versus Dexamethasone Implant Monotherapy for Retinal Vein Occlusion With Macular Edema." Ophthalmologica. Journal International D'ophtalmologie. International Journal of Ophthalmology. Zeitschrift Fur Augenheilkunde, vol. 228, no. 2, 2012, pp. 110-6.
Mayer WJ, Remy M, Wolf A, et al. Comparison of intravitreal bevacizumab upload followed by a dexamethasone implant versus dexamethasone implant monotherapy for retinal vein occlusion with macular edema. Ophthalmologica. 2012;228(2):110-6.
Mayer, W. J., Remy, M., Wolf, A., Kook, D., Kampik, A., Ulbig, M., Reznicek, L., & Haritoglou, C. (2012). Comparison of intravitreal bevacizumab upload followed by a dexamethasone implant versus dexamethasone implant monotherapy for retinal vein occlusion with macular edema. Ophthalmologica. Journal International D'ophtalmologie. International Journal of Ophthalmology. Zeitschrift Fur Augenheilkunde, 228(2), 110-6. https://doi.org/10.1159/000338732
Mayer WJ, et al. Comparison of Intravitreal Bevacizumab Upload Followed By a Dexamethasone Implant Versus Dexamethasone Implant Monotherapy for Retinal Vein Occlusion With Macular Edema. Ophthalmologica. 2012;228(2):110-6. PubMed PMID: 22739239.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Comparison of intravitreal bevacizumab upload followed by a dexamethasone implant versus dexamethasone implant monotherapy for retinal vein occlusion with macular edema. AU - Mayer,Wolfgang J, AU - Remy,Matthias, AU - Wolf,Armin, AU - Kook,Daniel, AU - Kampik,Anselm, AU - Ulbig,Michael, AU - Reznicek,Lukas, AU - Haritoglou,Christos, Y1 - 2012/06/23/ PY - 2011/12/28/received PY - 2012/04/05/accepted PY - 2012/6/29/entrez PY - 2012/6/29/pubmed PY - 2012/10/6/medline SP - 110 EP - 6 JF - Ophthalmologica. Journal international d'ophtalmologie. International journal of ophthalmology. Zeitschrift fur Augenheilkunde JO - Ophthalmologica VL - 228 IS - 2 N2 - PURPOSE: To compare the efficacy and safety of three intravitreal bevacizumab upload injections followed by a dexamethasone implant versus dexamethasone implant monotherapy in eyes with macular edema due to retinal vein occlusion. METHODS: Sixty-four eyes of 64 patients were included in this prospective, consecutive, nonrandomized case series: group 1 consisted of 38 patients (22 with central retinal vein occlusion, CRVO, 16 with branch retinal vein occlusion, BRVO) treated using a dexamethasone implant (Ozurdex) alone; group 2 consisted of 26 patients (14 CRVO, 12 BRVO) treated with three consecutive intravitreal bevacizumab injections at monthly intervals followed by a dexamethasone implant. In case of recurrence, both cohorts received further dexamethasone implants. Preoperatively and monthly best corrected visual acuity (BCVA, ETDRS), central retinal thickness (Spectralis-OCT), intraocular pressure, and wide-angle fundus photodocumentation (Optomap) were performed. The primary clinical endpoint was BCVA at 6 months after initiation of therapy. Secondary endpoints were central retinal thickness and safety of the therapy applied. RESULTS: In group 1, an increase in BCVA of 2.5 (±1.6) letters in the CRVO and of 13.0 (±3.2) letters in BRVO patients was seen after 6 months, in group 2 of 5.9 (±0.4) letters (CRVO) and 3.8 (±2.4) letters (BRVO), which was not statistically significant. When comparing the two treatment groups with respect to the type of vein occlusion, there was a significant advantage for BRVO patients for the dexamethasone implant monotherapy (BRVO patients in group 1, p = 0.005). Central retinal thickness showed a significant reduction after 6 months only in patients of group 1, both for CRVO (p = 0.01) and BRVO (p = 0.003). First recurrence after the first dexamethasone implant injection occurred after 3.8 months (mean) in CRVO and 3.5 months in BRVO patients (group 1), versus 3.2 and 3.7 months, respectively, in group 2. In group 1, 63.6% with CRVO and 50% with BRVO showed an increased intraocular pressure after treatment; in group 2, 57.1% with CRVO and 50.0% with BRVO, respectively. CONCLUSION: In CRVO, there was no difference between the two treatment strategies investigated. However, in BRVO, dexamethasone implant monotherapy was associated with better functional outcome. SN - 1423-0267 UR - https://www.unboundmedicine.com/medline/citation/22739239/Comparison_of_intravitreal_bevacizumab_upload_followed_by_a_dexamethasone_implant_versus_dexamethasone_implant_monotherapy_for_retinal_vein_occlusion_with_macular_edema_ L2 - https://www.karger.com?DOI=10.1159/000338732 DB - PRIME DP - Unbound Medicine ER -