THE EFFECT OF INTRAVITREAL DEXAMETHASONE IMPLANT ON MACULAR EDEMA AND VISUAL ACUITY IN RETINAL VEIN OCCLUSION: A SYSTEMATIC REVIEW AND META-ANALYSIS

Abstract

Background: Retinal vein occlusion (RVO) is characterized by the blockage of retinal veins that leads to the 
accumulation of fluid in the macula, resulting in macular edema (ME) and subsequent vision loss. Objective: The 
objective of this systematic review and meta-analysis was to evaluate the efficacy and safety of intravitreal 
dexamethasone implant (IDI) in the treatment of macular edema (ME) and visual acuity (VA) in patients with 
retinal vein occlusion (RVO). Methods: A systematic search was conducted in electronic databases including 
PubMed, EMBASE, and Cochrane Library. Studies reporting the outcomes of IDI in patients with RVO were 
included. The primary outcome measures were changes in best-corrected visual acuity (BCVA) and central retinal 
thickness (CRT) from baseline to the last follow-up. Results: A total of 10 studies including 823 patients with RVO 
were included in the meta-analysis. The pooled estimate showed statistically significant improvement in BCVA 
from baseline to the last follow-up 7.04, 95% confidence interval [CI] 4.67 to 9.42, P < 0.001) and a statistically 
significant reduction in CRT (WMD -185.23, 95% CI -223.68 to -146.78, P < 0.001). Subgroup analysis showed 
that the efficacy of IDI was similar in patients with branch retinal vein occlusion (BRVO) and central retinal vein 
occlusion (CRVO). The most common adverse event was intraocular pressure (IOP) elevation, which was generally 
manageable with topical medication. Conclusion: IDI is an effective and safe treatment option for ME and VA 
improvement in patients with RVO. The treatment effect was observed in both BRVO and CRVO.