title: Intravitreal dexamethasone implant versus anti-VEGF injection for treatment-naïve patients with retinal vein occlusion and macular edema: a 12-month follow-up study.
abstract: OBJECTIVE
  The objective of his study was to compare the visual and anatomical outcomes in treatment-naïve patients with macular edema secondary to retinal vein occlusion after intravitreal injections of dexamethasone implants (DEX) and anti-VEGF.
  
  
  METHODS
  One hundred two patients (64 in the anti-VEGF group, 38 in the DEX group) without previous treatment were included in this multi-center retrospective study and evaluated at baseline and 1, 3, 6, and 12 months after the onset of treatment. Patients were defined as "good responders" if central macular thickness (CMT) was less than or equal to 250 μm in TD-OCT or 300 μm in SD-OCT after the injections.
  
  
  RESULTS
  At month 3 (n = 102), BCVA had increased significantly, by 0.1 ± 0.3 logMAR in the anti-VEGF group (p = 0.04) and 0.4 ± 0.4 logMAR in the DEX group (p < 0.001); the difference between the two groups was statistically significant (p = 0.007). CMT decreased significantly, by 138 ± 201 μm (-19 %, p < 0.001) in the anti-VEGF group and 163 ± 243 μm (-21 %, p < 0.001) in the DEX group. After 3 months, five patients (13 %) in the DEX group and 20 (31 %) in the anti-VEGF group (p < 0.001) changed treatment. Among the 77 patients who did not switch from their initial treatment, no significant functional or anatomical difference between the two groups was observed at months 6 and 12. Elevation of intraocular pressure > 21 mmHg was more frequent in the DEX group (21 %) than in the anti-VEGF group (3 %, p = 0.008).
  
  
  CONCLUSIONS
  Visual acuity recovery was better in the DEX group than in the anti-VEGF group at month 3, but with no difference in CMT. In patients who did not change treatment, the long-term anatomical and visual outcome was similar between the DEX and anti-VEGF groups.
authors: Department of Ophthalmology, University Hospital, Grenoble, France. cchiquet@chu-grenoble.fr.|Grenoble Alpes University, Grenoble, 38041, France. cchiquet@chu-grenoble.fr.|Clinique Universitaire d'Ophtalmologie, CHU de Grenoble - University Hospital of Grenoble, 38043, Grenoble, Cedex 09, France. cchiquet@chu-grenoble.fr.
authors: C
authors: C
authors: Chiquet
authors: Department of Ophthalmology, University Hospital, Grenoble, France.|Grenoble Alpes University, Grenoble, 38041, France.
authors: C
authors: C
authors: Dupuy
authors: Department of Ophthalmology, University Hospital, Dijon, France.|Eye and Nutrition Research Group, CSGA, UMR1324 INRA, 6265 CNRS, Université de Bourgogne, Dijon, France.
authors: A M
authors: AM
authors: Bron
authors: Department of Ophthalmology, University Hospital, Grenoble, France.|Grenoble Alpes University, Grenoble, 38041, France.
authors: F
authors: F
authors: Aptel
authors: Department of Ophthalmology, University Hospital, Dijon, France.
authors: M
authors: M
authors: Straub
authors: Department of Ophthalmology, University Hospital, Dijon, France.
authors: R
authors: R
authors: Isaico
authors: Department of Ophthalmology, University Hospital, Grenoble, France.|Grenoble Alpes University, Grenoble, 38041, France.
authors: J P
authors: JP
authors: Romanet
authors: Department of Ophthalmology, University Hospital, Dijon, France.|Eye and Nutrition Research Group, CSGA, UMR1324 INRA, 6265 CNRS, Université de Bourgogne, Dijon, France.
authors: C
authors: C
authors: Creuzot-Garcher
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D020533:Angiogenesis Inhibitors / Q000627:therapeutic use*; D000068258:Bevacizumab / Q000627:therapeutic use; D003907:Dexamethasone / Q000008:administration & dosage*; D004343:Drug Implants; D005260:Female; D005500:Follow-Up Studies; D005938:Glucocorticoids / Q000008:administration & dosage*; D006801:Humans; D058449:Intravitreal Injections; D008269:Macular Edema / Q000188:drug therapy*; D008297:Male; D000069579:Ranibizumab / Q000627:therapeutic use; D012160:Retina / Q000473:pathology; D012170:Retinal Vein Occlusion / Q000188:drug therapy*; D012189:Retrospective Studies; D041623:Tomography, Optical Coherence; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors*; D014792:Visual Acuity / Q000187:drug effects / Q000502:physiology
chemical_list: D020533:Angiogenesis Inhibitors; D004343:Drug Implants; D005938:Glucocorticoids; C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A; D000068258:Bevacizumab; D003907:Dexamethasone; D000069579:Ranibizumab
keywords: Anti-VEGF; Bevacizumab; Dexamethasone implant; Macular edema; Ranibizumab; Retinal vein occlusion