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Quraish Ghadiali, Sabah Shah, Jane Myung, Ken Wald; Comparison of Retinal Atrophy after Laser, Anti-vasogenic Injections, or Combination Therapy in the Treatment of Branch Retinal Vein Occlusion. Invest. Ophthalmol. Vis. Sci. 2013;54(15):3839. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
To determine the extent of retinal atrophy in patients with branch retinal vein occlusion (BRVO) receiving either laser treatment, intravitreal anti-vascular endothelial growth factor (anti-VEGF) treatment or combination therapy for the treatment of macular edema (ME).
33 eyes with a history of BRVO treated with focal/grid laser alone, intravitreal anti-VEGF injections alone, or combination therapy for center-involving ME were reviewed in this retrospective study. Cirrus high definition optical coherence tomography Macular Cube Analysis was used to measure the retinal thickness from internal limiting membrane to retinal pigment epithelium using the Early Treatment Diabetic Retinopathy Study macular grid centered over the fovea. Retinal thinning was defined as a statistically significant difference between the affected and unaffected hemispheres of the same eye. Far paracentral and mid paracentral measurements from the grid were compared between the affected and unaffected hemispheres. The most recent OCT analysis with maximally resolved edema was used.
10 eyes received anti-VEGF injections alone with a mean of 5.5 injections per eye, 16 eyes received laser treatments alone with a mean of 2.1 treatments per eye, and 7 eyes received combination therapy with a mean of 2.3 laser treatments and 1.4 injections per eye. Corresponding affected hemisphere thicknesses were subtracted from unaffected hemisphere thicknesses. The mean difference between the affected and unaffected hemispheres in the far paracentral (mid paracentral) macular regions was 4.1 ± 25.0 (15.2 ± 23.4) μm for the anti-VEGF injection only group, 25 ± 25.23 (30.1 ± 17.44) μm for the laser treatment only group, and -4.1 ± 11.5 (15.1 ± 20.51) μm for the combination laser and anti-VEGF injection group. The mean difference in retinal thickness in the laser only and anti-VEGF only groups were not found to be significantly different for both the far periphery (p=0.29) or the mid periphery (p=0.32). Furthermore, analysis of variance across all three treatment groups showed no significant difference in both the far periphery (p=0.26) and the mid periphery (p=0.48).
There was no difference in resultant atrophy caused by laser alone, anti-VEGF injections alone, or combination therapy in the treatment of ME secondary to BRVO in the affected region of the macula.
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