2Uz. Dr., Abant İzzet Baysal Üniversitesi Tıp Fakültesi, Göz Hastalıkları AD, Bolu, Türkiye
3Yrd. Doç. Dr., Sağlık Bakanlığı Ardahan Devlet Hastanesi, Göz Hastalıkları Kliniği, Ardahan, Türkiye Objective: To compare the short-term ocular effects of intravitreal ranibizumab (IVR) and intravitreal dexamethasone implant (IVDI) in the treatment of recurrent macular edema related with central (CRVO) and branch retinal vein occlussion (BRVO) previously treated with IVDI.
Materials and Methods: The data of 52 patients that met the study criteria were investigated in our retrospective study. Thirty-four patients had BRVO and 18 patients had CRVO. All patients had fundus fl uorescein angiography (FFA) and optical coherence tomography (OCT) at first examination. All patients had IVDI injection fi rst because of the macular edema related with BRVO and CRVO. The mean time period between retinal vein occlussion occurrence and initial examination and treatment was 2 months. Patients were seperated into two groups. Twenty-five patients who had intravitreal ranibizumab injection after fi rst IVDI treatment due to the recurrence of macular edema were defi ned as Group 1. Twenty-seven patients who had 2 consecutive IVDI treatments due to the recurrence of macular edema defi ned as Group 2. All patients had a minimum follow-up of 12 months. Ocular findings of the groups were compared before the first IVDI injection, 1 month after the fi rst injections and 1 month after the second injections.
Results: There were no statically significant differance in best corrected visual acuity, intraocular pressure (IOP), central cornea thickness (CCT), retinal volume in central 1 mm and 3 mm, subfoveal, temporal and nasal choroid thickness and global retina nerve fiber layer (RNFL) thickness before and 1 month after fi rst injection between two groups (range of p value 0.05-0.88). IOP was 16.62±3.9 mmHg in group 1 and and 20.03±5.4 mmHg in Group 2. The fi rst month IOP of Group 1 and Group 2 were 16.62±3.94 and 20.03±5.40 mmHg, respectively after second injection and the difference was statistically signifi cant (p=0.02). Temporal choroidal thickness of Group 1 after second injection (237.72±75.4 ?m) was significantly thinner than the Group 2 (282.40±6.4 ?m) (p=0.03). We did not noticed statically significant difference in other parameters between the two groups after second injection.
Conclusions: IOP was higher in patients who undergone IVDI treatment twice due to the macular edema related with RVO than the patients who had ranibizumab injection after IVDI treatment.However, there was significant improvement in visual acuity and retinal thickness in IVDI group.
Keywords : Choroidal thickness, dexamethasone intravitreal implant, intraocular pressure, ranibizumab, retina thickness