June 2020
Volume 61, Issue 7
Free
ARVO Annual Meeting Abstract  |   June 2020
Comparison of real-world outcomes in patients with branch retinal vein occlusion (BRVO) related macular edema (ME) treated with anti-VEGF injections alone or anti-VEGF injections combined with focal laser
Author Affiliations & Notes
  • Cole Gross
    Callahan Eye Hospital, University of Alabama, Bimingham, Alabama, United States
    Retina Consultants of Alabama, University of Alabama, Birmingham, Alabama, United States
  • Meredith Thomley
    Medical School, University of Alabama, Birmingham, Alabama, United States
    Retina Consultants of Alabama, University of Alabama, Birmingham, Alabama, United States
  • Jason Crosson
    Retina Consultants of Alabama, University of Alabama, Birmingham, Alabama, United States
  • Ana Preda- Naumescu
    Medical School, University of Alabama, Birmingham, Alabama, United States
  • Kelly Chen
    Medical School, University of Alabama, Birmingham, Alabama, United States
  • Footnotes
    Commercial Relationships   Cole Gross, None; Meredith Thomley, None; Jason Crosson, None; Ana Preda- Naumescu, None; Kelly Chen, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science June 2020, Vol.61, 1343. doi:
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      Cole Gross, Meredith Thomley, Jason Crosson, Ana Preda- Naumescu, Kelly Chen; Comparison of real-world outcomes in patients with branch retinal vein occlusion (BRVO) related macular edema (ME) treated with anti-VEGF injections alone or anti-VEGF injections combined with focal laser. Invest. Ophthalmol. Vis. Sci. 2020;61(7):1343.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : Anti-VEGF injections are the mainstay of treatment for ME in patients with BRVO. Controversy exists as to whether focal laser improves outcomes in these patients. The purpose of this study was to assess outcomes in patients with BRVO related ME when given intravitreal anti-VEGF injections alone vs focal laser combined with anti-VEGF injections.

Methods : This was a retrospective cohort study of BRVO patients with ME who were treated in Alabama over 3 years. A total of 88 patients were included. One group received only anti-VEGF injections (n = 56) and the other group was treated with both anti-VEGF injections and focal laser (n = 32). The following outcome measures were evaluated and compared in both groups: initial and final visual acuities (VA), initial central subfield thickness on OCT, quantity of injections, quantity of lasers, percentage of patients with a gain of 3 lines of VA, percentage of patients with VA better than or equal to 20/40, and percentage of patients with VA worse than or equal to 20/200.

Results : There was no difference in initial VA (p = 0.913) or central subfield thickness between the two groups (p = 0.961). The injection only group required a median of 7 injections while the combination group required a median of 4 injections, but this was not a statistically significant difference (p = 0.117). There was no difference in final VA, the percentage of patients with 20/40 or better final VA, or the percentage of patients with 20/200 or worse final VA (p = 0.414, p = 0.662, and p = 0.213 respectively). The percentage of patients that gained 3 or more lines was 35.7 % in the injection only group and 25% in the combination group, and this was not statistically significant (p = 0.348). The injection only group gained a median of 2 lines, while the combination group gained a median of 2.5 lines, and this was not statistically significant (p = 0.833).

Conclusions : In the real-world clinical setting, focal laser did not decrease the number of injections required or improve the VA outcomes in BRVO related ME. Although visual outcomes were similar in both groups and a large-scale clinical trial would more fully address this question, focal laser does not appear to be of additional benefit in BRVO related ME in the anti-VEGF era.

This is a 2020 ARVO Annual Meeting abstract.

 

Changes in Visual Acuity

Changes in Visual Acuity

 

Number of Injections

Number of Injections

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