Management of macular edema secondary to branch retinal vein occlusion-combined treatment with intravitreal bevacizumab and ozurdex implant

Abstract

Purpose: To evaluate the efficacy and safety of a dexamethasone implant in combination with intravitreal\nbevacizumab injection in the management of macular edema secondary to branch retinal venous occlusion.\nMaterials and Methods: 10 eyes were prospectively investigated. Each eye was treated with intravitreal\nbevacizumab followed by intravitreal ozurdex at a two week interval. Recurrence of macular edema\nwas treated with ozurdex only. Patient were evaluated preoperatively with BCVA, IOP, OCT and fundus\nevaluation and followed up at 15 days, 2months and 4months of ozurdex injection. Fallow up all patient for\n1 year duration.\nResults: Mean BCVA at presentation was 0.81 log mar, and that improved to after 15 days of intravitreal\nbevacizumab was 0.55 log mar. At 15 days, 2 months and 4 months of intravitreal ozurdex implantation\nmean BCVA was 0.54logmar, 0.54 log mar and 0.6logmar respectively. Mean central foveal retinal\nthickness at presentation was 538 µm and reduced to 235 µm, after intravitreal bevacizumab. At 15 days,\n2 months and 4 months after intravitreal ozurdex implantation mean central foveal retinal thickness was\n182.14 µm, 189.28 µm and 352.14 µm respectively. Mean Intraocular pressure (IOP) was elevated about 1\nmm of Hg after bevacizumab, about 3 mm of Hg after 4 months of ozurdex with using single anti glaucoma\nmedication and one patient had progression of cataract after 2nd injection of ozurdex.\nConclusion: Combined treatment of intravitreal bevacizumab and ozurdex shows better and a sustained\nfunctional outcome. Increased intraocular pressure and cataract formation can be potential concerns and\nshould be monitored.\n\nKeywords:\xa0Macular edema secondary, Intravitreal bevacizumab, Intravitreal Ozurdex.