PURPOSE To assess the functional and anatomical outcomes of concurrent administration of aflibercept injection and dexamethasone (DEX) implant in patients with macular edema (ME) secondary to retinal vein occlusion (RVO), refractory to each of the two drugs previously administered as monotherapy. Secondary outcomes included the number of retreatments required in a 12-month follow-up and safety. METHODS This is a prospective, interventional case series of consecutive patients with refractory ME secondary to RVO, followed over a year. One injection of aflibercept was followed by a DEX implant on the same day; retreatment was driven by the persistence of ME on SD-OCT at least 4 months after the previous combined therapy. Central retinal thickness (CRT), best-corrected visual acuity (BCVA), and intraocular pressure (IOP) were collected at 1 month and then every 2 months until the end of follow-up. RESULTS Thirty eyes of 30 Caucasian patients were enrolled; mean duration of RVO before the first combined treatment was 25 ± 5 months (range 11 ± 30). Baseline BCVA was 0.73 ± 0.5 LogMAR, with no significant changes at 12 months (0.77 ± 0.51 μm, p = 0.2). Baseline CRT was 578.3 ± 161 μm, reducing to 352.5 ± 81 μm at 12 months (p = 0.003). Thirteen eyes (43.3%) required a second treatment. Twenty eyes (66.6%) showed no ME at the end of follow-up. One patient (3.3%) required topical IOP-lowering therapy during the study. CONCLUSION In eyes with ME secondary to RVO unresponsive to either aflibercept or DEX administered singularly, a combination therapy with simultaneous administration of aflibercept and DEX was effective in resolving ME, despite the absence of visual improvement. Earlier combined treatment in the course of the disease might lead to better functional outcomes.

中文翻译：

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同时进行玻璃体内地塞米松和阿柏西普治疗继发于视网膜静脉阻塞的难治性黄斑水肿。

目的评估在视网膜静脉阻塞（RVO）继发的黄斑水肿（ME）患者中并用abribercept注射液和地塞米松（DEX）植入物的功能和解剖学结局，这两种药物以前都是作为单一疗法给药的，因此难以治疗。次要结果包括为期12个月的随访和安全性所需的复治次数。方法这是前瞻性，干预性病例系列，连续病例为继发于RVO的难治性ME患者。当天注射一剂阿柏西普，随后植入DEX。在先前的联合治疗后至少4个月，ME对SD-OCT的持续性驱动了再次治疗。视网膜中央厚度（CRT），最佳矫正视力（BCVA），于1个月然后每2个月收集一次眼压（IOP），直到随访结束。结果招募了30名白人患者的30只眼。在首次联合治疗之前，RVO的平均持续时间为25±5个月（范围11±30）。基线BCVA为0.73±0.5 LogMAR，在12个月时无明显变化（0.77±0.51μm，p = 0.2）。基线CRT为578.3±161μm，在12个月时降至352.5±81μm（p = 0.003）。十三眼（43.3％）需要进行第二次治疗。随访结束时二十只眼（66.6％）未显示ME。在研究期间，一名患者（3.3％）需要局部降低IOP的治疗。结论对于RVO继发的ME患者，无论是单用abribercept还是DEX均无反应，联合使用aflibercept和DEX联合治疗可有效解决ME，尽管没有视觉改善。在疾病过程中早期进行综合治疗可能会导致更好的功能预后。