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목적 : To compare visual and anatomical outcomes of intravitreal injections of bevacizumab (Avastin®) vs. dexamethasone implant (Ozurdex®) for treatment of macular edema associated with branch retinal vein occlusion (BRVO)
방법 : We retrospectively reviewed the medical records of the patients who underwent intravitreal bevacizumab (26 eyes, IVB group) or 700 mg dexamethasone implant (20 eyes, IVD group) for treatment of macular edema associated with BRVO. We compared visual acuity, central macular thickness and average macular thickness of edematous side of inner (3 mm) and outer (6 mm) ring of ETDRS grid. We also measured ganglion cell inner plexiform layer (GCIPL) volume within 6 mm ETDRS grid. Linear mixed model analysis was done for comparison of serial changes of visual acuity and macular thickness.
결과 : Visual acuity of IVD group improved faster during the first months (p<0.001) and it was better than that of IVB group between 1 to 6 months (p=0.021). Central macular thickness (p=0.028) and macular thickness of edema side of 3 mm zone (p=0.008) were thinner in IVD group. IVD group also showed rapid resolution of macular edema at center 3 mm zone (p=0.037). The additional injection number in IVD group was also less than that of IVB group (p<0.001). However, there were no significant differences in terms of ellipsoid zone recovery rate (p=0.268) and GCIPL volume between two groups (p=0.459).
결론 : Intravitreal dexamethasone implant showed more rapid macular edema resolution than bevacizumab injection, however, there were no significant differences in ellipsoid zone recovery rate and GCIPL volume. Thus better initial visual outcome of IVD group might be related with potent drying up ability of dexamethasone compared to bevacizumab. However, further long-term follow up study is needed to check whether this trend is maintained.
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