Ranibizumab versus aflibercept for macular edema secondary to nonischemic central retinal vein occlusion in young adult patients

Abstract

Purpose The aim of this study was to compare the effect ranibizumab and aflibercept in the treatment of macular edema secondary to nonischemic central retinal vein occlusion (CRVO) in young adults.Patients and methods This is a prospective double-armed clinical trial that enrolled 40 eyes of 40 young adult patients (aged <50 years) with macular edema due to CRVO. The patients were randomized into two groups of 20 patients each. The first group received intravitreal injection of ranibizumab, whereas the second group received intravitreal aflibercept injection. All patients were subjected to measurement of best-corrected visual acuity, fluorescein angiography to detect retinal ischemia, and spectral domain optical coherence tomography to measure the macular edema at baseline and during a 12-month follow-up period. In each group, three intravitreal injections were given with a 1-month interval between injections.Results In group 1, the best-corrected visual acuity had a significant steady increase over time from a baseline value of 48.25±6.4 ETDRS letters to 55.85±10.3 letters at 1 year (P=0.017). Similarly, in group 2, there was also a significant steady increase over time from a baseline value of 55.9±7.2 letters to 60.75±8.4 letters at 1 year (P=0.035), with no statistically significant difference between the two groups (P>0.05). Regarding the central subfield thickness (CST), in the first group, a statistically significant decrease in the CST was reported over time from a baseline value of 557.85±69.7–295.1±55.9 μm at 1 year (P<0.001). Similarly, in the second group, the CST decreased significantly from a baseline value of 570.65±59.2–328.2±72.4 μm at 1 year, with no statistically significant difference between the two groups (P>0.05).Conclusion Ranibizumab and aflibercept showed a comparable promising outcome in the management of macular edema secondary to nonischemic CRVO in patients aged less than 50 years. Further multicentric randomized clinical trials are needed to confirm these results.