Is intravitreal dexamethasone implant a better choice than anti-VEGF therapy to treat complications of RVO in the retina?

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Published: Jun 30, 2019
DOI: https://doi.org/10.24292/01.OT.300619.07
Keywords:
retinal vein occlusion, intravitreal dexamethasone implant, anti-VEGF therapy

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Katarzyna Michalska-Małecka
1. Klinika Okulistyki, Katedra Okulistyki, Wydział Lekarski w Katowicach, Śląski Uniwersytet Medyczny w Katowicach. 2. Oddział Okulistyki Dorosłych, Uniwersyteckie Centrum Kliniczne im. prof. Kornela Gibińskiego, Śląski Uniwersytet Medyczny w Katowicach
Dorota Śpiewak
Oddział Okulistyki Dorosłych, Uniwersyteckie Centrum Kliniczne im. prof. Kornela Gibińskiego, Śląski Uniwersytet Medyczny w Katowicach

Abstract

Retinal vein occlusion (RVO) is a retinal vein disease whose complications can lead to decreased visual acuity and even blindness. The most common cause of decreased visual acuity during RVO is a chronic cystoid macular edema. The therapy involves medications with proven efficacy from the anti-VEGF group: ranibizumab, aflibercept, off-label bevacizumab and corticosteroids: dexamethasone in the form of a prolonged-release implant, fluocinolone, and off-label triamcinolone, characterized by short half-life. Scientific reports and clinical trials confirm the efficacy of anti-VEGF drugs and corticosteroids in the treatment of RVO. Therapy should be selected individually for each patient, including accompanying diseases, both systemic and local ailments. Anti-VEGF drugs and corticosteroids improve the retinal and choroidal morphology and restore the function of the retina by improving its sensitivity; confirmed in the microperimetric examination, which translates into improved visual acuity.


Anti-VEGF therapy is associated with the necessity of reinjection, especially in the case of recurrence of macular edema and decreased visual acuity, which may result in the possibility of a reduced response to the medicine being used. In this situation, it is recommended to switch to another anti-VEGF drug or to a dexamethasone treatment.

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1.
Michalska-Małecka K, Śpiewak D. Is intravitreal dexamethasone implant a better choice than anti-VEGF therapy to treat complications of RVO in the retina?. Ophthatherapy [Internet]. 2019Jun.30 [cited 2024Nov.24];6(2):112-9. Available from: https://journalsmededu.pl/index.php/ophthatherapy/article/view/940
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Vol 6 No 2 (2019)
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