Branch Retinal Vein Occlusion With Macular Edema Clinical Trial
Official title:
Bevacizumab Versus DEX Implant Followed by Bevacizumab in ME Secondary to BRVO
To evaluate the efficacy of sequential therapy with intravitreal dexamethasone implant followed by bevacizumab compared with bevacizumab monotherapy for macular edema (ME) secondary to retinal vein occlusion (RVO).
Retinal vein occlusion is the second most common retinal vessel disease following diabetic
retinopathy. It is divided into central retinal vein occlusion and retinal vein occlusion.
Visual disturbance resulting from retinal vein occlusion is mainly caused by macular edema,
and one of the main mechanisms of macular edema is increased vascular endothelial growth
factor. Increased vascular endothelial growth factor is known to cause macular edema by
breaking blood retinal barrier and causing leakage. For this reason, intravitreal injection
of anti - vascular endothelial growth factors is currently used to treat macular edema due to
retinal vein occlusion. Corticosteroid is a different mechanism from anti - vascular
endothelial growth factor, and it is the main mechanism to suppress macular edema, to
suppress the expression of inflammatory mediators, to block the inflammatory reaction
pathway, and to lower the vascular endothelial growth factor concentration in the vitreous
body. The dexamethasone implant in the vitreous cavity showed the maximum visual improvement
effect during 60 day after one injection, and the effect continued until about 90 days after
the injection. The same effect was obtained with a fewer injection times compared to the
injection of the anti-vascular endothelial growth factor and a variety of inflammatory. It is
also effective in patients who do not respond to anti-vascular endothelial growth factors by
effectively inhibiting cytokines and growth factors. However, steroids elevated intraocular
pressure, it is limited in repeated use.
Intravitreal dexamethasone implantation and anti-vascular endothelial growth factor showed
similar early vision improvement. The differences in these anatomical changes may be
different in long-term visual prognosis. After 3 doses of loading dose of anti-vascular
endothelial growth factor, each group was injected with anti-vascular endothelial growth
factor (VEGF) at each recurrence of macular edema and injected with anti-vascular endothelial
factor at each macular reattachment after dexamethasone injection. The results of this study
are as follows.
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