Ranibizumab versus Dexamethasone Implant in Macular Edema Secondary to Branch Retinal Vein Occlusion: Two-year Outcomes

Abstract

SIGNIFICANCE 

We compared the 24-month outcomes of ranibizumab and dexamethasone implants in treatment-naive branch retinal vein occlusion patients. Ranibizumab was effective in improving visual outcomes, whereas the dexamethasone implant was not.

PURPOSE 

The aim of this study was to compare the 2-year real-world outcomes of intravitreal ranibizumab with dexamethasone implants in patients with macular edema secondary to branch retinal vein occlusion.

METHODS 

The treatment-naive branch retinal vein occlusion patients with macular edema who were treated with intravitreal ranibizumab or dexamethasone implant were included retrospectively. Primary outcome measures were the change in best-corrected visual acuity and central retinal thickness.

RESULTS 

Eighty-seven eyes of 87 patients were included. Mean ± SD best-corrected visual acuity in the intravitreal ranibizumab group at baseline and 24 months was 0.64 ± 0.48 and 0.49 ± 0.44 logMAR (P < .05). Mean ± SD best-corrected visual acuity in the intravitreal dexamethasone implant group at baseline and 24 months was 0.98 ± 0.56 and 0.92 ± 0.61 logMAR (P > .05). Mean ± SD central retinal thickness in the intravitreal ranibizumab group at baseline and 24 months was 530 ± 150 and 337 ± 103 μm (P < .05). Mean ± SD central retinal thickness in the intravitreal dexamethasone implant group at baseline and 24 months was 591 ± 113 and 335 ± 99 μm (P < .05). Mean ± SD number of injections at 24 months was 5.6 ± 1.8 in the intravitreal ranibizumab group and 2.7 ± 1.1 in the dexamethasone implant group (P < .0001). Progression in lens opacity was detected in 5.7% of the phakic patients in the intravitreal ranibizumab group and 46.1% of them in the dexamethasone implant group (P < .0001). None of the patients in the intravitreal ranibizumab group and 9 (22.0%) of 41 patients in the dexamethasone implant group showed an increase of more than 10 mmHg in intraocular pressure.

CONCLUSIONS 

Ranibizumab was effective in the treatment of macular edema secondary to branch retinal vein occlusion in both visual and anatomical outcomes; however, dexamethasone implant was effective only in anatomical outcomes.