title: A 6-month, subject-masked, randomized controlled study to assess efficacy of dexamethasone as an adjunct to bevacizumab compared with bevacizumab alone in the treatment of patients with macular edema due to central or branch retinal vein occlusion.
abstract: OBJECTIVE
  To determine if intravitreal bevacizumab combined with the dexamethasone intravitreal implant 0.7 mg improves visual acuity and macular thickness more than bevacizumab monotherapy in eyes with macular edema due to branch and central retinal vein occlusions.
  
  
  METHODS
  Thirty eyes were randomly assigned to receive either combination therapy or bevacizumab monotherapy. All patients received intravitreal bevacizumab at baseline, followed by dexamethasone implants or sham injections 1 week later. Monthly bevacizumab injections were given if the central subfield thickness (CST) was >250 μm, and the combined group received a second implant at month 4 or 5 if CST was >250 μm.
  
  
  RESULTS
  At 6 months, several secondary endpoints were met. Patients receiving combined therapy required fewer bevacizumab reinjections compared to those receiving monotherapy (two versus three; P=0.02), experienced greater mean reductions in CST from randomization (-56 μm versus +45 μm; P=0.01), and were more likely to have resolved all edema (CST <250 μm) (7/11 versus 2/14; P=0.02). The primary endpoint was not met since mean visual acuity changes from baseline were similar in the two groups (P=0.75).
  
  
  CONCLUSIONS
  In patients with macular edema due to vein occlusions, bevacizumab with dexamethasone implants produces greater improvements in macular thickness compared to bevacizumab monotherapy, despite fewer bevacizumab injections.
authors.affiliation: Midwest Eye Institute, Indianapolis, IN, USA ; Department of Ophthalmology, Indiana University School of Medicine, Indianapolis, IN, USA.
authors.forename: Raj K
authors.initials: RK
authors.lastname: Maturi
authors.affiliation: Jaeb Center for Health Research, Tampa, FL, USA.
authors.forename: Vincent
authors.initials: V
authors.lastname: Chen
authors.affiliation: Jaeb Center for Health Research, Tampa, FL, USA.
authors.forename: Dan
authors.initials: D
authors.lastname: Raghinaru
authors.affiliation: Midwest Eye Institute, Indianapolis, IN, USA.
authors.forename: Laurie
authors.initials: L
authors.lastname: Bleau
authors.affiliation: Department of Ophthalmology, Mayo Clinic, Jacksonville, FL, USA.
authors.forename: Michael W
authors.initials: MW
authors.lastname: Stewart
keywords: branch retinal vein occlusion; central retinal vein occlusion; dexamethasone implant; vascular endothelial growth factor