THE OMAR STUDY: Comparison of Ozurdex and Triamcinolone Acetonide for Refractory Cystoid Macular Edema in Retinal Vein Occlusion.
OBJECTIVE
To compare the risks and benefits of adding either intravitreal dexamethasone implant (DEX) or preservative-free triamcinolone acetonide (TA) to bevacizumab monotherapy in refractory cystoid macular edema due to retinal vein occlusion.


METHODS
This is a multicenter, comparative, interventional, retrospective study that included 74 patients who were initially treated with intravitreal bevacizumab and later received either DEX or TA for the treatment of recalcitrant cystoid macular edema due to retinal vein occlusion. Main outcomes were best-corrected visual acuity, central macular thickness, cost of therapy, frequency of intravitreal injections, and side effects.


RESULTS
Thirty-nine patients received TA and 35 patients received DEX injections. Groups were similar in age and gender distribution. Although the mean central macular thickness improved significantly for all groups (P < 0.0001), logMAR best-corrected visual acuity did not change significantly after steroid introduction (P = 0.06). Frequency of any intravitreal injection decreased significantly from 0.66 ± 0.18 to 0.26 ± 0.08 injections per month after initiation of steroids (P < 0.0001). This effect was greater in the DEX groups (P < 0.0001). Monthly cost decreased with TA but increased with DEX.


CONCLUSIONS
Adding steroids improved anatomical outcome but did not affect final vision. Injection frequency decreased significantly after adding steroids, more so with DEX. There was no difference between TA and DEX regarding anatomical or functional outcomes or the incidence of side effects.
*Department of Ophthalmology and Visual Sciences, University of Louisville, Louisville, Kentucky; and †Department of Ophthalmology, Jordan University of Science and Technology, Irbid, Jordan.
Ahmet
A
Ozkok
Omar A
OA
Saleh
Douglas K
DK
Sigford
James W
JW
Heroman
Shlomit
S
Schaal
D000368:Aged; D000369:Aged, 80 and over; D020533:Angiogenesis Inhibitors / Q000191:economics / Q000627:therapeutic use*; D000068258:Bevacizumab / Q000191:economics / Q000627:therapeutic use*; D003907:Dexamethasone / Q000008:administration & dosage* / Q000191:economics; D004338:Drug Combinations; D016527:Drug Costs; D004343:Drug Implants; D005260:Female; D005451:Fluorescein Angiography; D005938:Glucocorticoids / Q000008:administration & dosage* / Q000191:economics; D006801:Humans; D058449:Intravitreal Injections; D008269:Macular Edema / Q000188:drug therapy* / Q000209:etiology / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D012170:Retinal Vein Occlusion / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology; D012189:Retrospective Studies; D014222:Triamcinolone Acetonide / Q000008:administration & dosage* / Q000191:economics; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors; D014792:Visual Acuity / Q000502:physiology
D020533:Angiogenesis Inhibitors; D004338:Drug Combinations; D004343:Drug Implants; D005938:Glucocorticoids; C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A; D000068258:Bevacizumab; D003907:Dexamethasone; D014222:Triamcinolone Acetonide