Abstract
Purpose :
Branch retinal vein occlusion (BRVO) is one of the most common retinal vasculopathies. Various studies have been conducted to evaluate the etiologies, treatment, and outcomes of BRVO. However, many of these studies have not identified trends stratified by quadrant. In this study, we have categorized and evaluated each of the quadrants individually for risk factors, presentation, treatment, and outcomes.
Methods :
This is a retrospective study conducted at a tertiary eye care center in a developing country from December 2017- December 2018. All patients with treatment-naive acute BRVO who completed a 2-year follow-up were included in the study. We defined 4 months (16 weeks) as acute. Patients with hemi-retinal or central retinal vein occlusion, multiple simultaneous retinal vein occlusions, and those who had received previous interventions for macular edema or other retinal pathology were excluded.
Results :
A total of 197 eyes with BRVO who had completed 2 years of follow-up were evaluated. At the time of diagnosis, mean age was 56.3 ±12.2 years. 57.8% of patients were male. The mean time from symptoms to diagnosis and initiation of treatment was 26 ±12 days and the mean visual acuity was 1.117 ± 0.46 log MAR. Sectors were characterized by the mean duration to achieve stability (MDS) and mean number of intravitreal injections (MII) of VEGF antagonists and corticosteroids. Superotemporal (ST) BRVO was the most common sector involved. The risk factors are summarized in Table 1. In total, 153 of 197 eyes attained stability which had an MDS of 29.7 weeks after an MII of 2.98. Macular vein occlusion attained stability the soonest with an MDS of 21.9 weeks after an MII of 2.57. Inferotemporal BRVO was the most resistant with an MDS of 36.6 weeks and MII of 3.65. The outcomes at 2 years are summarized in Table 2. In total, 33.5% of patients required treatment with photocoagulation due to neovascularization.
Conclusions :
This study reveals that different quadrants have different risk factors, treatment demands, and outcomes. It highlights the need for a quadrant-wise approach and suggests that the current “blanket” approach in management for BRVO could be further assessed.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.