Comparison of Intravitreal Ranibizumab, Aflibercept, and Dexamethasone Implant after Bevacizumab Failure in Macular Edema Secondary to Retinal Vascular Occlusions

Purpose: To compare the visual and anatomic outcomes of macular edema secondary to retinal vein occlusion after switching from bevacizumab to ranibizumab, aflibercept, or dexamethasone implant. Methods: Fifteen eyes were switched to ranibizumab, 12 to aflibercept, and 10 to dexamethasone. At 3, 6, 9, and 12 months, the outcome measures were visual acuity (VA) and central macular thickness (CMT). Results: One year after the switch, CMT decreased from 430.11 +/- 91.21 to 291.86 +/- 43.87 mu m (p < 0.001). VA increased in 59.5% of the eyes. No difference between the groups was found in those outcomes at 1 year, but the number of injections varied: 3.30 +/- 0.95 for dexamethasone, 6.50 +/- 2.11 for aflibercept, and 8.27 +/- 2.37 for ranibizumab (p < 0.001). Conclusions: Most of the eyes that failed initial bevacizumab therapy benefit from switching to another modality. The number of required injections during the first year after the switch varies. (C) 2017 S. Karger AG, Basel