Abstract :
Purpose: To evaluate the efficacy and safety of a dexamethasone implant in combination with intravitreal
bevacizumab injection in the management of macular edema secondary to branch retinal venous occlusion.
Materials and Methods: 10 eyes were prospectively investigated. Each eye was treated with intravitreal
bevacizumab followed by intravitreal ozurdex at a two week interval. Recurrence of macular edema
was treated with ozurdex only. Patient were evaluated preoperatively with BCVA, IOP, OCT and fundus
evaluation and followed up at 15 days, 2months and 4months of ozurdex injection. Fallow up all patient for
1 year duration.
Results: Mean BCVA at presentation was 0.81 log mar, and that improved to after 15 days of intravitreal
bevacizumab was 0.55 log mar. At 15 days, 2 months and 4 months of intravitreal ozurdex implantation
mean BCVA was 0.54logmar, 0.54 log mar and 0.6logmar respectively. Mean central foveal retinal
thickness at presentation was 538 µm and reduced to 235 µm, after intravitreal bevacizumab. At 15 days,
2 months and 4 months after intravitreal ozurdex implantation mean central foveal retinal thickness was
182.14 µm, 189.28 µm and 352.14 µm respectively. Mean Intraocular pressure (IOP) was elevated about 1
mm of Hg after bevacizumab, about 3 mm of Hg after 4 months of ozurdex with using single anti glaucoma
medication and one patient had progression of cataract after 2nd injection of ozurdex.
Conclusion: Combined treatment of intravitreal bevacizumab and ozurdex shows better and a sustained
functional outcome. Increased intraocular pressure and cataract formation can be potential concerns and
should be monitored.
Keyword :
Macular edema secondary, Intravitreal bevacizumab, Intravitreal Ozurdex.