To evaluate the efficiency of Dexamethasone implants to Ranibizumab injections in macular edema secondary to retinal vein occlusion (RVO) in clinical setting. Design: This is a retrospective comparative cohort study


44 eyes of 44 newly diagnosed patients with macular edema secondary to either branch retinal vein occlusion or central retinal vein occlusion. Included patient presented with visual acuity 0.3logMAR to 2.3logMAR, and central subfield thickness greater than 300 microns on Ocular Coherence Tomography. Status of retinal ischaemia and/or neovascularization on Fluorescein Angiography was not considered as exclusion criteria.


A retrospective cohort of 2 comparative group including 27 patients receiving Ranibizumab injections were compared to 17 patients receiving Dexamethasone implant. Best Corrected Visual Acuity, and Optic Coherence Tomography were done at baseline, and 3 months and 6 months. Main outcome measures compared best corrected visual acuity in logMAR and central foveal subfield thickness between both groups during the 6 months period.


Of the 44 patients included, 20 cases were suffering from branch retinal vein occlusion and 24 cases were suffering from central retinal vein occlusion; 31 cases were non-ischaemic and 13 cases were ischaemic RVO. The mean presenting visual acuity was 1.08logMAR (+/-0.38) in Ranibizumab group vs 0.89logMAR (+/-0.40) in Dexamethasone implant group (p=0.129). The mean visual acuity at 6 months was 0.87logMAR (+/-0.43) in Ranibizumab group vs 0.76logMAR (+/-0.45) in Dexamethasone implant group. There was no significant difference in best corrected visual acuity between the 2 groups at 3 months and 6 months (p=0.46, p=0.61 respectively). Regarding the central subfield thickness, the baseline thickness was 614um +/- 144 in ranibizumab group vs 548um+/-160 in dexamethasone group (p=0.21). The dexamethasone implant group had a statistically significant thinner central subfield thickness at 3 months (p=0.019, Chi-square); such difference was not observed at 6 months. There was no significant difference between the intraocular pressure for Dexamethasone group before and at 3 months post implantation (p>0.05). Conclusion: Both drugs provided effective improvements in visual acuity and reduction in macular edema measured by central subfield thickness reduction. There is no evidence in showing superiority of either treatment for visual outcome at 6 month. However, Dexamathasone implant provides a better reduction of macular edema at 3 months compared to Ranibizumab, such difference in macular thickness reduction was not observed at 6 months.