Combination therapy with dexamethasone intravitreal implant and macular grid laser in patients with branch retinal vein occlusion.

Abstract

PURPOSE: To test a combination of dexamethasone intravitreal implant with macular grid laser formacular edema in patients with branch retinal vein occlusion (BRVO). DESIGN: Prospective interventional, randomized, multicenter study. METHODS: Patients with macular edema secondary to BRVO underwent an Ozurdex intravitreal implant at baseline. After 1 month, patients were randomly assigned to 2 study groups. Patients in Group 1 were followed up monthly and retreated with Ozurdex implant whenever there was a recurrence of macular edema or a decrease in best-corrected visual acuity (BCVA). In Group 2 patients macular grid laser was performed between weeks 6 and 8. After that, patients were followed up and retreated as for Group 1. RESULTS: In Group 1 at 4 months, mean BCVA was 0.49 ± 0.35 logMAR and central retinal thickness (CRT) was 391±172mm; both improved significantly at 6months, to 0.32 ± 0.29 logMAR and 322 ± 160mm, respectively. In Group 2, CRT was reduced significantly to 291 ± 76 mmat 4months, andBCVAimproved to0.25±0.20logMAR.At the final visit, BCVA was 0.18 ± 0.14 logMAR and mean CRT was 271 ± 44 mm. The number of Ozurdex implants at 4 months was 12 of 25 (48%) in Group 1 patients vs 3 of 25 (12%) inGroup 2 patients (P[.012). At 6months 3 of 25 patients (12%) in Group 1 vs 0 of 25 (0%) in Group 2 (P [ .23) were retreated. CONCLUSIONS: The combination of Ozurdex implant and macular grid laser is synergistic in increasing BCVA and lengthening the time between injections