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Yoshitsugu Saishin, Yuka Ito, Masashi Kakinoki, Masahito Ohji; Topical bromfenac as an adjunctive treatment with intravitreal ranibizumab for macular edema associated with branch retinal vein occlusion. Invest. Ophthalmol. Vis. Sci. 2017;58(8):3653.
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© ARVO (1962-2015); The Authors (2016-present)
Intravitreal injection of ranibizumab (IVR) is an effective treatment for patients with macular edema (ME) secondary to branch retinal vein occlusion (BRVO). Repeated treatments are often required to control ME in many patients and it would be a burden. The purpose of this study is to assess the efficacy of topical bromfenac (0.1%) as an adjunctive therapy for patients with ME secondary to BRVO.
This is a prospective, double-masked, placebo-controlled study. Forty-five patients with ME due to BRVO were enrolled and randomized to topical bromfenac or saline adjunctive to IVR in a double-masked fashion. Patients received single IVR. Additional IVR injections were administered as needed if the prespecified criteria were met during the study period. Patients were examined at baseline and then monthly from months 1 to 12. The primary endpoint was the number of IVR injections over 12 months. The visual and anatomic responses were also compared.
Four patients did not complete the study because of loss to follow-up and 22 patients in bromofenac group and 19 patients in the control group completed 12-month follow-up. The mean number of IVR injections over 12 months was 2.0 in thetopical bromfenac group and 3.1 in the topical saline group. The mean total number of injections was significantly smaller in the topical bromfenac group than in the topical saline group (p=0.032). There was no significant difference in the mean logMAR BCVA at baseline between the two groups (p=0.26). In the topical bromfenac group, the mean logMAR BCVA improved significantly from 0.57 at baseline to 0.16 at month 12 (p<0.05). In the topical saline group, the mean baseline logMAR BCVA improved significantly from 0.56 at baseline to 0.15 at month 12 (p<0.05). The mean logMAR BCVA did not differ significantly at month 12 between the two groups (p=0.51). In the topical bromfenac group, the mean CFT decreased significantly from 563 μm at baseline to 278 μm at month 12 (p<0.05). In the topical saline group, the mean CFT decreased significantly from 618 μm at baseline to 250 μm at month 12 (p<0.05).
Topical bromfenac might reduce the frequency of IVR over12 months in patients with ME secondary to BRVO, though there was not a significant difference in improvement of visual acuity and retinal thickness between the two groups.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.
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