Background: The aim of this work was to compare the efficacy of intravitreal dexamethasone implant (Ozurdex) and intravitreal ranibizumab (Lucentis) in the treatment of macular edema (ME) caused by retinal vein occlusion (RVO). Methods: Thirty-two ME cases treated with Ozurdex and 32 ME cases treated with ranibizumab were enrolled, with 26 central (C)RVO and 6 branch (B)RVO subjects in each group. We compared the results of best-corrected visual acuity (BCVA), central retinal thickness, number of injections, and intraocular pressure (IOP) at 1, 2, 3, and 6 months after injection. Results: BCVA in both groups at each follow-up were significantly increased compared to baseline with no statistical difference between the groups. Ozurdex and ranibizumab successfully reduced CMT at each follow-up. Both CRVO and BRVO patients had significant between-group differences in the mean number of injections. Among the CRVO patients, IOP in the Ozurdex group was significantly increased compared to baseline and the ranibizumab group at 1, 2, and 3 months postinjection. Conclusions: Intravitreal injection of Ozurdex and ranibizumab can effectively control ME secondary to RVO and increase a patient's BCVA. The advantages of Ozurdex are fewer injections and longer efficacy, while the advantages of ranibizumab include fewer side effects.

Keywords:
Macular edema, Dexamethasone, Ranibizumab, Retinal vein occlusion
1.
McIntosh RL, Rogers SL, Lim L, et al: Natural history of central retinal vein occlusion: an evidence-based systematic review. Ophthalmology 2010;117:1113-1123.
2.
Rogers SL, McIntosh RL, Lim L, et al: Natural history of branch retinal vein occlusion: an evidence-based systematic review. Ophthalmology 2010;117:1094-1101.
3.
Noma H, Funatsu H, Yamasaki M, et al: Pathogenesis of macular edema with branch retinal vein occlusion and intraocular levels of vascular endothelial growth factor and interleukin-6. Am J Ophthalmol 2005;140:256-261.
4.
London NJ, Chiang A, Haller JA: The dexamethasone drug delivery system: indications and evidence. Adv Ther 2011;28:351-366.
5.
Kuppermann BD, Blumenkranz MS, Haller JA, et al: Randomized controlled study of an intravitreous dexamethasone drug delivery system in patients with persistent macular edema. Arch Ophthalmol 2007;125:309-317.
6.
Haller JA, Bandello F, Belfort Jr R, et al: Randomized, sham-controlled trial of dexamethasone intravitreal implant in patients with macular edema due to retinal vein occlusion. Ophthalmology 2010;117:1134-1146.
7.
Ferrara N, Damico L, Shams N, et al: Development of ranibizumab, an anti-vascular endothelial growth factor antigen binding fragment, as therapy for neovascular age-related macular degeneration. Retina 2006;26:859-870.
8.
Campochiaro PA, Heier JS, Feiner L, et al: Ranibizumab for macular edema following branch retinal vein occlusion: six-month primary end point results of a phase III study. Ophthalmology 2010;117:1102-1112.
9.
Brown DM, Campochiaro PA, Bhisitkul RB, et al: Sustained benefits from ranibizumab for macular edema following branch retinal vein occlusion: 12-month outcomes of a phase III study. Ophthalmology 2011;118:1594-1602.
10.
Brown DM, Campochiaro PA, Singh RP, et al: Ranibizumab for macular edema following central retinal vein occlusion: six-month primary end point results of a phase III study. Ophthalmology 2010;117:1124-1133.
11.
Campochiaro PA, Brown DM, Awh CC, et al: Sustained benefits from ranibizumab for macular edema following central retinal vein occlusion: twelve-month outcomes of a phase III study. Ophthalmology 2011;118:2041-2049.
12.
Heier JS, Campochiaro PA, Yau L, et al: Ranibizumab for macular edema due to retinal vein occlusions: long-term follow-up in the HORIZON trial. Ophthalmology 2012;119:802-809.
13.
Dai H, Gu X: Ranibizumab intravitreal injection procedures. Chin J Ophthalmol Med 2012;2:61-62.
14.
Gu X, Yu X, Dai H: Intravitreal injection of ranibizumab for treatment of age-related macular degeneration: effects on serum VEGF concentration. Curr Eye Res 2014;39:518-521.
15.
Chiquet C, Dupuy C, Bron AM, et al: Intravitreal dexamethasone implant versus anti-VEGF injection for treatment-naive patients with retinal vein occlusion and macular edema: a 12-month follow-up study. Graefes Arch Clin Exp Ophthalmol 2015;253:2095-2102.
16.
Hoerauf H, Feltgen N, Weiss C, et al: Clinical efficacy and safety of ranibizumab versus dexamethasone for central retinal vein occlusion (COMRADE C): a European Label Study. Am J Ophthalmol 2016;169:258-267.
© 2017 S. Karger AG, Basel
2017
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.