Purpose: To evaluate the efficacy and safety of a dexamethasone implant (Ozurdex) alone or in combination with bevacizumab.
Methods: Sixty-four eyes were prospectively investigated. Group 1 (22 central retinal vein occlusion (CRVO) and 16 branch retinal vein occlusion (BRVO)) was treated with Ozurdex alone, and group 2 (14 CRVO and 12 BRVO) was treated with three consecutive bevacizumab injections followed by Ozurdex. Recurrences were treated with Ozurdex only. Patients were seen preoperatively and thereafter in monthly intervals. The primary end point was best-corrected visual acuity (BCVA) at 12 months.
Results: In group 1, BCVA improved by 6.6 (±1.7) letters in CRVO and 7.8 (±2.9) in BRVO patients, and in group 2 by 9.8 (±1.0) vs 9.4 (±2.1) letters. A significant difference was only seen between CRVO patients in group 1 and 2 at 12 months (P<0.05). Recurrence after the first Ozurdex injection occurred after 3.8 (CRVO) and 3.5 months (BRVO) in group 1, vs 3.2 and 3.7 months in group 2. Elevated intraocular pressure (>5 mm Hg) was measured in approximately 40% cataract progression requiring surgery in about 50% of eyes after three Ozurdex injections.
Conclusion: Combined treatment showed slightly better functional outcome for CRVO patients. Increased intraocular pressure and cataract progression was frequent and should be considered when an individual treatment is planned.