Combination Therapy with Dexamethasone Intravitreal Implant and Macular Grid Laser in Patients with Branch Retinal Vein Occlusion – Accepted Manuscript

Abstract: Purpose: To test a combination of dexamethasone intravitreal implant with macular grid laser for macular edema in patients with branch retinal vein occlusion (BRVO).Design: Prospective interventional, randomized, multi-center studyMethods: Patients with macular edema secondary to BRVO underwent an Ozurdex® intravitreal implant at baseline. After one 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 week 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 to 391 ± 172 μm; both improved significantly at 6 months, to 0.32 ± 0.29 and 322 ± 160 μm respectively. In Group 2, CRT was reduced significantly to 291 ± 76 μm at 4 months, and BCVA improved to 0.25 ± 0.20. At the final visit, BCVA was 0.18 ± 0.14 logMAR and mean CRT was 271 ± 44 μm. The number of Ozurdex® implants at 4 months was 12/25 (48%) in Group 1 vs 3/25 (12%) in Group 2 (p=0.012). At 6 months 3/25 (12%) in Group 1 vs 0/25 (0%) in Group 2 (p=0.23) were retreated.Conclusions: The combination of Ozurdex® implant and macular grid is synergistic in increasing BCVA and lengthening the time between injections.