Effect of Alternate Treatment with Intravitreal Corticosteroid and Anti-VEGF for Macular Edema Secondary to Retinal Vein Occlusion.

Young Hwan Bae,Jin Young Kim,So Hyun Bae,Dae Joong Ma,Hakyoung Kim,Seong Mi Kim,Lisa Toto

doi:10.1155/2021/5948113

Abstract

Purpose To evaluate whether treatment with intravitreal corticosteroid and anti-vascular endothelial growth factor (VEGF) injections alternately can improve treatment outcomes of macular edema (ME) caused by retinal vein occlusion (RVO). Methods This dual-center retrospective study included 112 eyes with treatment-naïve ME secondary to RVO that were alternately treated with intravitreal corticosteroid and anti-VEGF injections (33 eyes, alternate group) or treated only with intravitreal anti-VEGF injections (79 eyes, anti-VEGF group) on a pro re nata basis. Results During the 12-month follow-up period, the alternate group achieved a visual acuity gain of 0.39 logMAR, while the anti-VEGF group achieved a gain of 0.21 logMAR (P=0.042). The alternate group demonstrated a reduction in the central macular thickness of 229.9-μm, while the anti-VEGF group achieved a reduction of 220.1 μm (P=0.887). The alternate group required an average of 5.2 injections, while the anti-VEGF received 4.2 injections (P < 0.001). In a propensity score-matched cohort to compensate for the differences in the injection numbers between the two groups, the alternate group achieved a better visual acuity gain than the anti-VEGF group at month 12 (0.39 logMAR vs. 0.17 logMAR, P=0.048). Conclusions In ME secondary to RVO, treatment with intravitreal corticosteroid and anti-VEGF injections alternately resulted in a more favorable visual outcome compared with intravitreal anti-VEGF monotherapy.

Highlights

Retinal vein occlusion (RVO) is the second most common retinal vascular disorder following diabetic retinopathy [1, 2]
RVO is associated with several complications, including macular edema (ME), vitreous hemorrhage, optic neuropathy, macular ischemia, or even tractional retinal detachment, which can result in visual loss [5]
Retreatment was typically performed in cases with a recurrence of ME, defined as the presence of intraretinal cysts on optical coherence tomography (OCT) images and associated with visual impairment. e drug for intravitreal injection, e.g., 1.25 mg/0.05 mL bevacizumab (Avastin; Genentech/Roche, South San Francisco, California, USA), 0.5 mg/0.05 mL ranibizumab (Lucentis; Genentech/Roche), 2.0 mg/0.05 mL aflibercept (Eylea; Regeneron, Tarrytown, New York, USA), 4 mg/0.1 mL triamcinolone acetonide

Summary

Introduction

Retinal vein occlusion (RVO) is the second most common retinal vascular disorder following diabetic retinopathy [1, 2]. Is study assessed the efficacy of alternate treatment with intravitreal corticosteroid and anti-VEGF injections in improving the visual and anatomical outcomes of patients with ME secondary to RVO in a real-life setting.

Results

Conclusion