Dexamethasone intravitreous implant versus bevacizumab for central retinal vein occlusion-related macular oedema: a prospective randomized comparison.

BACKGROUND: To compare the efficiency of dexamethasone implants to bevacizumab injections in macular oedema secondary to central retinal vein occlusion.

DESIGN: Randomized clinical trial at Cairo University Hospitals.

PARTICIPANTS: Sixty eyes of 60 newly diagnosed patients with macular oedema secondary to central retinal vein occlusion with best corrected visual acuity 0.3 logMAR (6/12) to counting fingers, no evidence of retinal ischaemia and/or neovascularization on fluorescein angiography and central subfield thickness ≥300 μm on ocular coherence tomography.

METHODS: Patients were randomly assigned (30 eyes each group) to either intravitreal dexamethasone implant or bevacizumab injections repeated whenever needed. Best corrected visual acuity and ocular coherence tomography were done at baseline and monthly for 6 months.

MAIN OUTCOME MEASURES: Comparing best corrected visual acuity and central foveal subfield thickness between both groups during the 6-month period.

RESULTS: There was no significant difference in best corrected visual acuity between the two groups during the 6 months (P-values > 0.05). The bevacizumab group had a statistically significant thinner central subfield thickness at 1 month (P-value 0.006) and no statistically significant difference for the rest of the 6 months (P-values > 0.05). There was a statistically significant higher intraocular pressure for dexamethasone implant group (compared with bevacizumab) at 3-6 months (P-values < 0.05), respectively.

CONCLUSION: Both drugs provided effective best corrected visual acuity improvements and central subfield thickness reductions that showed no statistically significant difference between the two groups.