Abstract
Purpose :
To evaluate the use of monthly treatment of anti-angiogenic plus laser photocoagulation reduces the recurrence rate of macular edema (ME) secondary to (BRVO) after maximal visual acuity (VA) stabilization.
Methods :
12-month prospective, interventional study with patients with ME due to BRVO. Main inclusion criteria: BRVO ≤ 12 months; best corrected visual acuity (BCVA) ≥ 20/320 and ≤ 20/40. Main exclusion criteria: previous intravitreous drugs or macular laser treatment, macular surgery, cataract extraction in the previous 6 months, macular edema due to other causes.
Ophthalmological examination was performed at baseline, including OCT and fluorescein angiography (FA). Patients were treated monthly with 1.25 mg intravitreous bevacizumab (IVB) up to six injections. BCVA and OCT were measured in each visit. After the third injection, if the BCVA reached a plateau (same measurement of visit 3) or achieved 20/20 with no foveal OCT fluid, the injections were withheld, and laser was applied. Follow-up was performed monthly with BCVA and OCT. If after the third injection the patient did not reach the VA plateau and/or had foveal fluid on OCT, the injections were continued until reaching the plateau or VA 20/20 or up to the maximum of 6 injections. Retreatment criteria were: central macular thickness (CMT) > 300 microns with foveal fluid and/or loss ≥ 10 letters. This study was approved by Ethics Committee of the Institution (CAAE: 50931115.4.0000.0088) and is registered on Australian New Zealand Clinical Trials Registry (ACTRN12617001436369).
Results :
Twelve patients were included; six were men. Mean age was 63.9 years-old (range, 44-89 years-old). Five patient (41.6%) had systemic hypertenson, 2 patients (16.6%) had diabetes mellitus, 2 patients (16.6%) controlled glaucoma. Mean BCVA at baseline was 20/100 (range, 20/200 – 20/30); baseline mean CMT was 494.3µm (range, 228-818 µm); the mean number of injections was 4.2 (range, 3-6), CMT after third injection was 253.5 µm (range, 190-320 µm). Five patients (41.6%) needed retreatment.
Conclusions :
Our study showed that combined treatment IVB + laser therapy using a VA-based regimen resulted in improvement of ME and in BCVA. Five patient needed retreatment. No significant adverse effects occurred. The mean number of injections was 4.2.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.