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Eun S. Huh, Jennifer I. Lim; Macular Edema Associated with Branch Retinal Vein Occlusion and Anti-VEGF Therapy. Invest. Ophthalmol. Vis. Sci. 2012;53(14):914.
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Macular edema associated with branch retinal vein occlusion (BRVO) has been shown to respond to anti-vascular endothelial growth factor (VEGF) therapy. We sought to determine the visual and anatomic outcomes in eyes with macular edema associated with BRVO treated with an as needed regimen of anti-VEGF therapy and to compare the outcomes between bevacizumab and ranibizumab.
We retrospectively reviewed the medical records of patients receiving intravitreal anti-VEGF therapy for macular edema associated with BRVO at our institution over a period of 34 months. Patients with at least 3 months of follow-up and follow-up optical coherence tomography (OCT) were included. Data collected include demographics, duration of vein occlusion, visual acuity, OCT data, dates of injection, anti-VEGF treatment, and past medical history. Data were analyzed and student’s t-test was utilized to determine statistical significance.
21 eyes of 20 patients were included for analysis. The average duration of the vein occlusion, noted as the onset of decreased vision in the affected eye, was 30 months (range 1 to 120 months, median 18 months). Patients received a mean of 3.6 injections and were followed up for a mean of 6.1 months. The mean initial visual acuity at presentation prior to initiating anti-VEGF therapy at our institution was 20/132. Final or last recorded mean visual acuity after receiving anti-VEGF therapy was 20/78. Mean OCT central macular thickness decreased by 21.4% from baseline. 12 patients received as needed injections of bevacizumab and 9 patients received as needed injections of ranibizumab. The mean increase in visual acuity was 0.2 logMAR units for the bevacizumab eyes and 0.22 log MAR units for the ranibizumab eyes (p = 0.95). The mean percentage decrease in OCT central macular thickness was 18.1% in bevacizumab eyes and 25.8% in ranibizumab eyes (p = 0.55). Excluding the eyes that received prior treatment, the bevacizumab eyes (n = 10) improved visual acuity by 0.15 logMAR units while the ranibizumab eyes (n = 4) improved visual acuity by 0.58 logMAR units (p = 0.18). The mean OCT central macular thickness decreased by 15.8% in the bevacizumab eyes and by 46.1% in the ranibizumab eyes (p = 0.06).
As needed anti-VEGF therapy in eyes with macular edema associated with BRVO resulted in increased visual acuity and decreased central macular thickness. Although there is no statistically significant difference in change in visual acuity or OCT central macular thickness between the bevacizumab compared to the ranibizumab treated eyes, for treatment naïve eyes, visual acuity improved and central macular thickness decreased more in the ranibizumab-treated eyes.
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