Is intravitreal dexamethasone implant a better choice than anti-VEGF therapy to treat complications of RVO in the retina?

Retinal vein occlusion (RVO) is a retinal vein disease whose complications can lead to decreased visual acuity and even blindness. The most common cause of decreased visual acuity during RVO is a chronic cystoid macular edema. The therapy involves medications with proven efficacy from the anti-VEGF group: ranibizumab, aflibercept, off-label bevacizumab and corticosteroids: dexamethasone in the form of a prolonged-release implant, fluocinolone, and off-label triamcinolone, characterized by short half-life. Scientific reports and clinical trials confirm the efficacy of anti-VEGF drugs and corticosteroids in the treatment of RVO. Therapy should be selected individually for each patient, including accompanying diseases, both systemic and local ailments. Anti-VEGF drugs and corticosteroids improve the retinal and choroidal morphology and restore the function of the retina by improving its sensitivity; confirmed in the microperimetric examination, which translates into improved visual acuity. Anti-VEGF therapy is associated with the necessity of reinjection, especially in the case of recurrence of macular edema and decreased visual acuity, which may result in the possibility of a reduced response to the medicine being used. In this situation, it is recommended to switch to another anti-VEGF drug or to a dexamethasone treatment.