Intravitreal aflibercept therapy for central retinal vein occlusion with serous retinal detachment is associated with a more rapid anatomical response and more significant gains to vision than single-dose dexamethasone implantation, according to findings published in Clinical and Experimental Optometry.

Patients (N=68) admitted to the University of Health Sciences Turkey, Okmeydani Training and Research Hospital with serous retinal detachment-type macular edema secondary to non-ischemic central retinal vein occlusion were recruited for this study. Investigators randomized patients to receive 3 monthly aflibercept injections (n=37) or single-dose dexamethasone implantation (n=31). Improvements in best-corrected visual acuity (logMAR), macular edema, and central retinal thickness were assessed through 6 months.

Patients in the aflibercept and dexamethasone cohorts were aged mean 60±9.65 and 57.77±11.88 years, 23 and 16 were women, 16% and 16% had diabetes, 32% and 38% had hypertension, and 27% and 32% had hypercholesterolemia, respectively.


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At baseline, the aflibercept and dexamethasone groups did not differ in logMAR (P =.880), central retinal thickness (P =.839), or height of serous retinal detachment (P =.620). At 6 months, the investigators observed superior improvements in logMAR (P =.033) and central retinal thickness (P <.001) among the aflibercept cohort but no significant difference in height of serous retinal detachment (P =.246). The improvement was more rapid among the aflibercept recipients, exhibiting a significant improvement of central retinal thickness within the first month of treatment (P =.011).

Compared with baseline, significant improvements among each group were observed for all 3 study endpoints (all P <.001).

The adverse events of cataract progression (aflibercept: n=2; dexamethasone: n=2) and increase in intraocular pressure (aflibercept: n=1; dexamethasone: n=5) were reported.

This study was limited by its small sample size and limited follow-up duration.

Reference

Bayat AH, Akpolat Ç, Livan H, Bölükbaşi S, Elçioğlu MN. Comparison of the effects of aflibercept and dexamethasone in central retinal vein occlusion with serous retinal detachment. Clin Exp Optom. Published online June 17, 2021. doi:10.1080/08164622.2021.1927676