Intravitreal Dexamethasone Implant (Ozurdex®) versus Anti-VEGF Injection in Branch Retinal Vein Occlusion: An Optical Coherence Tomography Angiography study

Author: Rahma Saidane (Tunisia)

Co-authors: Racem Choura, Asma Khallouli, Dhouha Gouider, Slim Selmi, Afef Maalej, Riadh Rannen

Purpose

To evaluate and compare changes in retinal vasculature after intravitreal dexamethasone implant (Ozurdex) insertion and antivascular endothelial growth factor (anti-VEGF) injection in patients with branch retinal vein occlusion (BRVO) using optical coherence tomography angiography (OCT-A).

Setting/Venue

Department of Ophthalmology of the Military Hospital of Tunis, Tunisia

Methods

We retrospectively analyzed 20 patients with unilateral BRVO. Subjects were divided into two groups according to the treatment agent: Ozurdex (n = 8) and anti-VEGF (n = 12). Spectral domain (SD) OCT and OCT-A 6 × 6 mm scans of the superficial (SCP) and deep capillary plexus (DCP) were analyzed in all eyes. Intravitreal implant and anti-VEGF injections were performed following a PRN regimen. The specific anti-VEGF agent used was chosen among bevacizumab and aflibercept.

Results

Of the 20 patients (mean age 60 ± 8.9 years; 11 male and 9 female) with unilateral BRVO, there was a greater vascular reperfusion of the choriocapillaris in the intravitreal Ozurdex implant group than in the anti-VEGF group (p = 0.011). The mean baseline VD of the SCP and the DCP was similar between groups in all quadrants. At 12 months, the parafoveal VD of the SCP and DCP was significantly higher in the Ozurdex group than in the anti-VEGF group (p < 0.05 for all). Further, there was a statistically significant positive correlation between the improvement of visual acuity and increased VD in both groups (R = 0.648, p = 0.022 and R = 0.544, p = 0 .032, respectively for Ozurdex and anti-VEGF).

Conlusions

Our findings suggest that the intravitreal Ozurdex implant induced higher retinal vascular reperfusion compared with anti-VEGF injection. Macular VDs can be used as biomarkers to evaluate the visual prognosis in long-term follow-up for the treatment of BRVO.

Financial Disclosure

The authors declare no conflict of interest