The Effects of Epiretinal Membranes on the Treatment Outcomes of Dexamethasone Implants in Diabetic Macular Edema: A Real-Life Study

Abstract PurposeTo evaluate and compare the functional and anatomical outcomes of intravitreal ranibizumab (IVR) and aflibercept (IVA) treatments in patients with diabetic macular edema (DME).MethodsFour hundred three eyes of 235 naïve patients who underwent IVR or IVA treatment for diabetic macular edema and followed up to 36 months included in this retrospective, real-life study. All patients underwent 3 loading doses and followed up with a PRN regimen. Best corrected visual acuity (BCVA) and central macular thickness (CMT) were measured at baseline, year 1, 2 and 3. ResultsThere were 198 eyes in IVR group and 205 eyes in IVA group. The changes in mean BCVA were 0.09±0.32 vs 0.17±0.41 logMAR (p=0.042) at year 1, 0.09±0.37 vs 0.12±0.45 logMAR (p=0.512) at year 2 and 0.13± 0.36 vs 0.15±0.48 logMAR (p=0.824) at year 3 in IVA and IVR groups, respectively. The baseline mean BCVA were lower (p=0.004) in IVA group. In terms of CMT changes, there were no differences between groups. ConclusionAt year 1, change in mean BCVA was statistically significantly higher in IVA group, however this difference did not persist at year 2 and 3. Both ranibizumab and aflibercept treatments achieved a good long-term visual and anatomical response in DME patients.

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Real-life study of the use of anti-VEGF therapy versus dexamethasone implant for treatment of macular edema in retinal vein occlusion

Graefe s Archive for Clinical and Experimental Ophthalmology ◽

10.1007/s00417-021-05146-8 ◽

2021 ◽

Author(s):

Manuel Casselholm de Salles ◽

David Epstein

Keyword(s):

Macular Edema ◽

Retinal Vein Occlusion ◽

Real Life ◽

Central Vein ◽

Life Study ◽

Vein Occlusion ◽

Anti Vegf ◽

Long Time ◽

Real Life Study

Abstract Purpose To investigate the long-time outcome of patients with branch vein occlusion (BRVO) and central vein occlusion (CRVO) treated with anti-VEGF injections compared to the dexamethasone (DEX) implant. Methods This retrospective real-life study included all 492 patients presenting with retinal vein occlusion (RVO) during 2012–2013 at St. Erik Eye Hospital. Maximum follow-up was 5 years. Results The mean time of follow-up for patients treated for macular edema was 33.2±17.7 and 34.3±18.1 months in the BRVO and CRVO groups, respectively. At the end of follow-up, the best-corrected visual acuity improved +9.8±20.4 Early Treatment Diabetic Retinopathy Study letters in BRVO patients receiving anti-VEGF therapy while patients treated with the DEX implant lost −2.1±23.4 letters (p<0.05). CRVO patients treated with anti-VEGF therapy improved +0.2±27.6 letters while patients receiving a DEX implant lost −9.7±32.6 letters (p=0.11). Overall, in RVO patients treated with anti-VEGF injections, the central retinal thickness decreased to 322±174μm compared to 398±174 μm in patients treated with the DEX implant (p<0.05). Conclusions In a clinical setting, a substantial part of patients is still in follow-up a long time after presentation. The visual and anatomical outcomes were better in patients treated with anti-VEGF agents compared to subjects receiving a DEX implant.

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