Effect of simultaneous intravitreal ranibizumab and extended-release dexamethasone injection on patients with naïve versus refractory retinal vein occlusion macular edema: a prospective, multicenter, and interventional open-label study

AIM: To evaluate the efficacy and safety of concurrent intravitreal ranibizumab (IVR) and extended-release dexamethasone injections (Dex-I) in naïve and refractory patients with retinal vein occlusion macular edema (RVO-ME). METHODS: This was a prospective, interventional, and open-label clinical tr...

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Main Authors: Yao-Yao Sun, Jie Meng, Shan-Shan Li, Qin Xiao, Tian-Zi Zhang, Heng Miao, Ming-Wei Zhao, Hui-Jun Qi
Format: Article
Language:English
Published: Press of International Journal of Ophthalmology (IJO PRESS) 2025-05-01
Series:International Journal of Ophthalmology
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Online Access:http://ies.ijo.cn/en_publish/2025/5/20250511.pdf
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author Yao-Yao Sun
Jie Meng
Shan-Shan Li
Qin Xiao
Tian-Zi Zhang
Heng Miao
Ming-Wei Zhao
Hui-Jun Qi
author_facet Yao-Yao Sun
Jie Meng
Shan-Shan Li
Qin Xiao
Tian-Zi Zhang
Heng Miao
Ming-Wei Zhao
Hui-Jun Qi
author_sort Yao-Yao Sun
collection DOAJ
description AIM: To evaluate the efficacy and safety of concurrent intravitreal ranibizumab (IVR) and extended-release dexamethasone injections (Dex-I) in naïve and refractory patients with retinal vein occlusion macular edema (RVO-ME). METHODS: This was a prospective, interventional, and open-label clinical trial. There were two groups: naïve and refractory patients (received ≥5 times of previous IVR within one year prior to enrollment) enrolled. Patients received IVR and Dex-I concurrently and re-combination therapy was required if one or more retreatment criteria were met. IVR and Dex-I were given pro re nata (PRN). The mean changes in best-corrected visual acuity (BCVA) and central macular thickness (CMT) were measured as main outcomes. RESULTS: Totally 63 patients (63 eyes) completed the entire follow-up (31 naïve and 32 refractory patients). At month 12, the change in BCVA was greater in the naïve group than in the refractory group [19.67±11.7 (95%CI: 15.03, 24.31) letters vs 11.74±11.18 (95%CI: 7.32, 16.16) letters, P=0.014). There was no difference between the two groups of mean macular thickness reduction [364.26±215.29 (95%CI: 279.09, 449.43) μm vs 410.19±204.34 (95%CI: 329.35, 491.02) μm, P=0.43). The mean co-injection numbers were 2.52±0.58 (95%CI: 2.29, 2.75) and 2.33±0.55 (95%CI: 2.11, 2.55) in both groups (P=0.24), respectively. The retreatment interval was 115.81±13.79 d (95%CI: 110.36, 121.27) and 122.74±14.06 d (95%CI: 119.93, 133.56) in both groups (P=0.073). There was no significant difference in the incidence of glaucoma or the progression of cataracts between the two groups. CONCLUSION: In both naïve and refractory RVO-ME patients, IVR combined with Dex-I is effective. The initial combination therapy for naïve patients demonstrates more efficient improvement in BCVA and may reduce total injection numbers compared to refractory patients.
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spelling doaj-art-e48619b00a194de79daacfeeee0786d22025-08-20T03:14:58ZengPress of International Journal of Ophthalmology (IJO PRESS)International Journal of Ophthalmology2222-39592227-48982025-05-0118586086710.18240/ijo.2025.05.1120250511Effect of simultaneous intravitreal ranibizumab and extended-release dexamethasone injection on patients with naïve versus refractory retinal vein occlusion macular edema: a prospective, multicenter, and interventional open-label studyYao-Yao Sun0Jie Meng1Shan-Shan Li2Qin Xiao3Tian-Zi Zhang4Heng Miao5Ming-Wei Zhao6Hui-Jun Qi7Hui-Jun Qi. Department of Ophthalmology, Peking University People's Hospital, Beijing 100034, China. drqihuijun@126.comEye Institute of Shandong, State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Qingdao 266000, Shandong Province, ChinaDepartment of Ophthalmology, Qilu Hospital of Shandong University, Jinan 250012, Shandong Province, ChinaDepartment of Ophthalmology, Affiliated Hospital of Inner Mongolia University for the Nationalities, Tongliao 028000, Inner Mongolia Autonomous Region, ChinaDepartment of Ophthalmology, Affiliated Hospital of Inner Mongolia University for the Nationalities, Tongliao 028000, Inner Mongolia Autonomous Region, ChinaDepartment of Ophthalmology, Peking University People's Hospital, Beijing 100034, China; Beijing Key Laboratory of Ocular Disease and Optometry Science, Beijing100034, ChinaDepartment of Ophthalmology, Peking University People's Hospital, Beijing 100034, China; Beijing Key Laboratory of Ocular Disease and Optometry Science, Beijing100034, ChinaDepartment of Ophthalmology, Peking University People's Hospital, Beijing 100034, China; Beijing Key Laboratory of Ocular Disease and Optometry Science, Beijing100034, ChinaAIM: To evaluate the efficacy and safety of concurrent intravitreal ranibizumab (IVR) and extended-release dexamethasone injections (Dex-I) in naïve and refractory patients with retinal vein occlusion macular edema (RVO-ME). METHODS: This was a prospective, interventional, and open-label clinical trial. There were two groups: naïve and refractory patients (received ≥5 times of previous IVR within one year prior to enrollment) enrolled. Patients received IVR and Dex-I concurrently and re-combination therapy was required if one or more retreatment criteria were met. IVR and Dex-I were given pro re nata (PRN). The mean changes in best-corrected visual acuity (BCVA) and central macular thickness (CMT) were measured as main outcomes. RESULTS: Totally 63 patients (63 eyes) completed the entire follow-up (31 naïve and 32 refractory patients). At month 12, the change in BCVA was greater in the naïve group than in the refractory group [19.67±11.7 (95%CI: 15.03, 24.31) letters vs 11.74±11.18 (95%CI: 7.32, 16.16) letters, P=0.014). There was no difference between the two groups of mean macular thickness reduction [364.26±215.29 (95%CI: 279.09, 449.43) μm vs 410.19±204.34 (95%CI: 329.35, 491.02) μm, P=0.43). The mean co-injection numbers were 2.52±0.58 (95%CI: 2.29, 2.75) and 2.33±0.55 (95%CI: 2.11, 2.55) in both groups (P=0.24), respectively. The retreatment interval was 115.81±13.79 d (95%CI: 110.36, 121.27) and 122.74±14.06 d (95%CI: 119.93, 133.56) in both groups (P=0.073). There was no significant difference in the incidence of glaucoma or the progression of cataracts between the two groups. CONCLUSION: In both naïve and refractory RVO-ME patients, IVR combined with Dex-I is effective. The initial combination therapy for naïve patients demonstrates more efficient improvement in BCVA and may reduce total injection numbers compared to refractory patients.http://ies.ijo.cn/en_publish/2025/5/20250511.pdfretinal vein occlusionmacular edemaprospective clinical trialanti-vascular endothelial growth factordexamethasone implant
spellingShingle Yao-Yao Sun
Jie Meng
Shan-Shan Li
Qin Xiao
Tian-Zi Zhang
Heng Miao
Ming-Wei Zhao
Hui-Jun Qi
Effect of simultaneous intravitreal ranibizumab and extended-release dexamethasone injection on patients with naïve versus refractory retinal vein occlusion macular edema: a prospective, multicenter, and interventional open-label study
International Journal of Ophthalmology
retinal vein occlusion
macular edema
prospective clinical trial
anti-vascular endothelial growth factor
dexamethasone implant
title Effect of simultaneous intravitreal ranibizumab and extended-release dexamethasone injection on patients with naïve versus refractory retinal vein occlusion macular edema: a prospective, multicenter, and interventional open-label study
title_full Effect of simultaneous intravitreal ranibizumab and extended-release dexamethasone injection on patients with naïve versus refractory retinal vein occlusion macular edema: a prospective, multicenter, and interventional open-label study
title_fullStr Effect of simultaneous intravitreal ranibizumab and extended-release dexamethasone injection on patients with naïve versus refractory retinal vein occlusion macular edema: a prospective, multicenter, and interventional open-label study
title_full_unstemmed Effect of simultaneous intravitreal ranibizumab and extended-release dexamethasone injection on patients with naïve versus refractory retinal vein occlusion macular edema: a prospective, multicenter, and interventional open-label study
title_short Effect of simultaneous intravitreal ranibizumab and extended-release dexamethasone injection on patients with naïve versus refractory retinal vein occlusion macular edema: a prospective, multicenter, and interventional open-label study
title_sort effect of simultaneous intravitreal ranibizumab and extended release dexamethasone injection on patients with naive versus refractory retinal vein occlusion macular edema a prospective multicenter and interventional open label study
topic retinal vein occlusion
macular edema
prospective clinical trial
anti-vascular endothelial growth factor
dexamethasone implant
url http://ies.ijo.cn/en_publish/2025/5/20250511.pdf
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