title: A Review of Randomized Trials of Approved Pharmaceutical Agents for Macular Edema Secondary to Retinal Vein Occlusion.
abstract: There are 3 approved pharmaceutical agents for treating macular edema secondary to retinal vein occlusion (RVO): dexamethasone (a corticosteroid) implant and ranibizumab and aflibercept (both antivascular endothelial growth factor agents). All show a superior ability to improve vision and reduce macular thickness in comparison with sham injections or macular grid laser treatment. Prompt treatment with these agents may lead to a better outcome. A review of randomized trials of injected aflibercept or ranibizumab reveals protocol variations. They include "as needed" injections until functional and anatomical changes are achieved, preceded by either 1 injection or 3 to 6 monthly injections as loading doses. Ocular and systemic adverse effects of vascular endothelial growth factor antagonists for macular edema secondary to RVO are rarely severe. The antiedematous response to a single intravitreal dexamethasone implant is maximal 1 to 3 months after the injection. Intraocular pressure elevation and cataract aggravation should be monitored after the use of intravitreal dexamethasone implants. Intravitreal dexamethasone implants and ranibizumab injections reduce not only macular edema, but also the risk of retinal ischemia and neovascularization in patients with RVO.
authors.affiliation: From the Department of Ophthalmology, Far Eastern Memorial Hospital, New Taipei City; Department of Medicine, National Yang Ming University, Taipei City; Department of Healthcare Administration and Department of Nursing, Oriental Institute of Technology, New Taipei City; and Department of Medicine, National Taiwan University, Taipei City, Taiwan.
authors.forename: Jia-Kang
authors.initials: JK
authors.lastname: Wang
mesh_terms: D020533:Angiogenesis Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use*; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized / Q000008:administration & dosage; D003907:Dexamethasone / Q000008:administration & dosage; D004343:Drug Implants; D005260:Female; D005938:Glucocorticoids / Q000008:administration & dosage; D006801:Humans; D058449:Intravitreal Injections; D008269:Macular Edema / Q000188:drug therapy* / Q000209:etiology; D016032:Randomized Controlled Trials as Topic; D000069579:Ranibizumab / Q000008:administration & dosage; D040262:Receptors, Vascular Endothelial Growth Factor / Q000008:administration & dosage; D011993:Recombinant Fusion Proteins / Q000008:administration & dosage; D012170:Retinal Vein Occlusion / Q000150:complications* / Q000188:drug therapy; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors; D014792:Visual Acuity
chemical_list: D020533:Angiogenesis Inhibitors; D000893:Anti-Inflammatory Agents; D061067:Antibodies, Monoclonal, Humanized; D004343:Drug Implants; D005938:Glucocorticoids; D011993:Recombinant Fusion Proteins; D042461:Vascular Endothelial Growth Factor A; C533178:aflibercept; D003907:Dexamethasone; D040262:Receptors, Vascular Endothelial Growth Factor; D000069579:Ranibizumab