Journal Basic Info

  • Impact Factor: 1.989**
  • H-Index: 6
  • ISSN: 2637-4625
  • DOI: 10.25107/2637-4625
**Impact Factor calculated based on Google Scholar Citations. Please contact us for any more details.

Major Scope

  •  Urological Surgery
  •  Podiatric Surgery
  •  Surgery & Surgical Research
  •  General Surgery
  •  Spine Surgery
  •  Cancer Surgery
  •  Bariatric Surgery
  •  Plastic Surgery

Abstract

Citation: World J Surg Surg Res. 2019;2(1):1126.DOI: 10.25107/2637-4625.1126

Outcomes of Combination Therapy Using Aflibercept and Dexamethasone Intravitreal Implant for Macular Edema Secondary to Retinal Vein Occlusion

Walid Harb, Georgio Chidiac and Georges Harb

Department of Ophthalmology, Centre Hospitalier Universitaire Notre Dame des Secours, Lebanon
Department of Ophthalmology, Holy Spirit University of Kaslik, Lebanon
Department of Ophthalmology, Clinique du Levant, Lebanon
Department of Ophthalmology, Lebanese University, Lebanon

*Correspondance to: Georges Harb 

 PDF  Full Text Research Article | Open Access

Abstract:

Purpose: To evaluate the efficacy of the combination therapy of intravitreal aflibercept 2 mg (Eylea®) and a sustained-release dexamethasone 0.7 mg intravitreal implant (Ozurdex®) in providing a prolonged effect in eyes with Macular Edema (ME) secondary to branch or Central Retinal Vein Occlusion (RVO).
Methods: In this interventional, prospective case series, 36 eyes of 36 patients with treatment-naive ME secondary to RVO were recruited between December 2016 and September 2017 and were studied over a 12-month follow-up period. Patients were included in analysis if they had a central macular thickness (CMT) >300 μm, and best-corrected visual acuity (BCVA) of 20/40 or worse. All patients were treated with an Eylea® injection followed 2 weeks later by an Ozurdex® injection. The same cycle was repeated if BCVA decreased by 6 or more Snellen letters from the best measurement and/or if CMT increased by >50 μm from the lowest measurement. Intraocular Pressure (IOP) was evaluated 2 and 4 weeks after each Eylea® injection. CMT, BCVA and IOP were measured 6 weeks after the beginning of each cycle and subsequently every 4 weeks until retreatment is needed. The primary outcome measure was the time to retreatment. The secondary outcome measures included CMT, BCVA and IOP.
Results: Seven patients (19.44%) needed no retreatment after one-year follow-up. Twenty-nine patients (80.56%) needed ≥ 1 retreatment, and the first reinjection was at 142.17 ± 39.13 days. There was a significant peak decrease in CMT from 482.44 ± 79.78 μm at baseline to 209.78 ± 13.14 μm (P<0.0001). In addition, mean BCVA improved from initially 0.706 ± 0.23 logarithm of the minimum angle of resolution (logMAR) units to a maximum of 0.336 ± 0.09 logMAR units during the study period (P<0.0001). An increase of IOP was seen in 7 patients out of 36 (19.44%) and was controlled by topical treatment.
Conclusion: Aflibercept with dexamethasone implants provided a predictable duration of effect with low intravitreal retreatment rates at first year, and achieved significant anatomical and visual outcomes in eyes with ME secondary to RVO.

Keywords:

Macular edema; Retinal vein occlusion; Aflibercept; Dexamethasone; Combination therapy

Cite the Article:

Harb W, Chidiac G, Harb G. Outcomes of Combination Therapy Using Aflibercept and Dexamethasone Intravitreal Implant for Macular Edema Secondary to Retinal Vein Occlusion. World J Surg Surgical Res. 2019; 2: 1126.

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