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목적 : To evaluate the efficacy of sequential therapy with intravitreal dexamethasone implant followed by bevacizumab compared with bevacizumab monotherapy for macular edema (ME) secondary to retinal vein occlusion (BRVO).
방법 : Fourty patients with naive ME secondary to BRVO followed up for at least 6 months were divided into two groups: single intravitreal dexamethasone implant followed by bevacizumab PRN (DEX group, 20 eyes) and bevacizumab PRN monotherapy (BVZ group, 20 eyes). Outcome measures included Snellen visual acuity, anatomical change of optical coherence tomography (OCT), and number of injections during follow-up period.
결과 : The overall average number of injections during this time was 2.00±0.78 in DEX group, and 3.61±1.15 in BVZ group (p<0.001). Mean baseline VA was 0.85 ± 0.47 and 0.72 ± 0.58 in DEX and BVZ group, respectively. Both groups showed significant visual improvement from baseline during the entire follow-up period. DEX group showed a trend toward faster recovery of photoreceptor integrities, however, there was no significant difference in overall each recovery rates (p = 0.126, p=0.230, p=0.490, log-rank test, respectively).
결론 : DEX as initial option in the patients with ME led to rapid recovery of retinal structures than intravitreal bevacizumab monotherapy. Early and frequent injections of anti-VEGF with stringent retreatment guideline are required to maintain it achieving better visual gain during longer follow-up period.
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