Significance: We compared the 24-month outcomes of ranibizumab and dexamethasone implants in treatment-naive branch retinal vein occlusion patients. Ranibizumab was effective in improving visual outcomes, whereas the dexamethasone implant was not.
Purpose: The aim of this study was to compare the 2-year real-world outcomes of intravitreal ranibizumab with dexamethasone implants in patients with macular edema secondary to branch retinal vein occlusion.
Methods: The treatment-naive branch retinal vein occlusion patients with macular edema who were treated with intravitreal ranibizumab or dexamethasone implant were included retrospectively. Primary outcome measures were the change in best-corrected visual acuity and central retinal thickness.
Results: Eighty-seven eyes of 87 patients were included. Mean ± SD best-corrected visual acuity in the intravitreal ranibizumab group at baseline and 24 months was 0.64 ± 0.48 and 0.49 ± 0.44 logMAR (P < .05). Mean ± SD best-corrected visual acuity in the intravitreal dexamethasone implant group at baseline and 24 months was 0.98 ± 0.56 and 0.92 ± 0.61 logMAR (P > .05). Mean ± SD central retinal thickness in the intravitreal ranibizumab group at baseline and 24 months was 530 ± 150 and 337 ± 103 μm (P < .05). Mean ± SD central retinal thickness in the intravitreal dexamethasone implant group at baseline and 24 months was 591 ± 113 and 335 ± 99 μm (P < .05). Mean ± SD number of injections at 24 months was 5.6 ± 1.8 in the intravitreal ranibizumab group and 2.7 ± 1.1 in the dexamethasone implant group (P < .0001). Progression in lens opacity was detected in 5.7% of the phakic patients in the intravitreal ranibizumab group and 46.1% of them in the dexamethasone implant group (P < .0001). None of the patients in the intravitreal ranibizumab group and 9 (22.0%) of 41 patients in the dexamethasone implant group showed an increase of more than 10 mmHg in intraocular pressure.
Conclusions: Ranibizumab was effective in the treatment of macular edema secondary to branch retinal vein occlusion in both visual and anatomical outcomes; however, dexamethasone implant was effective only in anatomical outcomes.