title: Retinal Vein Occlusions: Therapeutic Switch in Macular Oedema Treatment with a 12-Month Follow-Up.
abstract: OBJECTIVE
  To compare the visual and anatomical outcomes of patients with macular oedema secondary to retinal vein occlusion (RVO) after a switch from bevacizumab to intravitreal injection of a dexamethasone implant (IVI-DEX) or conversely.
  
  
  METHODS
  48 patients - 40 in the antivascular endothelial growth factor (VEGF) DEX sequence (AD group), 8 in the DEX anti-VEGF sequence (DA group) - were included in this multicentre retrospective study and evaluated at baseline, 1, 3, 6 and 12 months after the switch. The outcome measurements were visual acuity (VA) and central macular thickness (CMT) evaluated by spectral domain optical coherence tomography. Patients were defined as 'good responders' if CMT was ≤ 300 µm after the switch.
  
  
  RESULTS
  VA significantly improved at 1 month in the AD group (p = 0.03) but not in the DA group (p = 0.40). CMT decreased significantly in the AD group at 1, 6 and 12 months (p = 0.002, p = 0.005 and p = 0.002, respectively). In the DA group, VA did not change from baseline at any time point, and CMT decreased at 1 month (p = 0.02) but not later on.
  
  
  CONCLUSIONS
  In patients with macula oedema secondary to RVO, the switch from bevacizumab to IVI-DEX seems more beneficial in terms of short-term VA and long-term reduction of CMT than the DEX anti-VEGF agent sequence.
authors.affiliation: Department of Ophthalmology, University Hospital, Grenoble, France.
authors.forename: Christophe
authors.initials: C
authors.lastname: Chiquet
authors.forename: Alain M
authors.initials: AM
authors.lastname: Bron
authors.forename: Morgane
authors.initials: M
authors.lastname: Straub
authors.forename: Caroline
authors.initials: C
authors.lastname: Dupuy
authors.forename: Rodica
authors.initials: R
authors.lastname: Isaico
authors.forename: Florent
authors.initials: F
authors.lastname: Aptel
authors.forename: Catherine
authors.initials: C
authors.lastname: Creuzot-Garcher
mesh_terms: D000368:Aged; D020533:Angiogenesis Inhibitors / Q000627:therapeutic use*; D000068258:Bevacizumab / Q000627:therapeutic use*; D003907:Dexamethasone / Q000008:administration & dosage*; D004343:Drug Implants; D057915:Drug Substitution; D005260:Female; D005500:Follow-Up Studies; D005938:Glucocorticoids / Q000008:administration & dosage*; D006801:Humans; D058449:Intravitreal Injections; D008269:Macular Edema / Q000188:drug therapy* / Q000209:etiology / Q000473:pathology / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D012170:Retinal Vein Occlusion / Q000150:complications*; D012189:Retrospective Studies; D041623:Tomography, Optical Coherence; D014792:Visual Acuity / Q000502:physiology
chemical_list: D020533:Angiogenesis Inhibitors; D004343:Drug Implants; D005938:Glucocorticoids; D000068258:Bevacizumab; D003907:Dexamethasone