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Anti-VEGF for macular edema secondary to branch retinal vein occlusion: twelve-month outcomes of one initial injection to three monthly injections based on visual acuity Hiroki Kawano 1,2 , Keita Yamakiri 2 , Akinori Uemura 2 1Kawano Eye Clinic 2Department of Ophthalmology, Kagoshima City Hospital pp.1401-1407
Published Date 2022/10/15
DOI https://doi.org/10.11477/mf.1410214530

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Abstract Purpose:To report the 12-month outcomes of a treatment protocol in which the number of intravitreal injections of anti-VEGF agents in the loading phase was determined based on the best corrected visual acuity(BCVA)before injection in the treatment of macular edema(ME)associated with branch retinal vein occlusion(BRVO).

Subjects and method:The subjects were 21 eyes of 21 patients with ME associated with BRVO(9 men and 12 women, mean age 69 years)treated between July 2017 and March 2020. The number of injections in the loading phase was determined based on the following criteria and thereafter administered as needed(PRN):1 injection for BCVA of 20/40 or better(1+PRN group), 2 monthly injections for BCVA of 20/50-20/100(2+PRN group), and 3 monthly injections for BCVA of 20/150 or worse(3+PRN group). The changes in BCVA, the time interval from the end of the loading phase to re-injection, the total number of injections over 12 months, and the changes in the central macular thickness(CMT)in each group were investigated.

Results:Of the 21 patients, 9 were in the 1+PRN group, 9 in the 2+PRN group, and 3 in the 3+PRN group. The mean number of injections over 12 months was 3.6(2.8 in the 1+PRN group, 3.9 in the 2+PRN group, and 5.0 in the 3+PRN group). In each group, BCVA and CMT improved at the end of the loading phase and maintained up to 12 months after the first injection. BCVA 1 month after the end of the loading phase was significantly correlated with BCVA 12 months after the first injection(p<0.01, r=0.79).

Conclusion:The treatment protocol of determining the number of injections in the loading phase based on pre-injection BCVA was useful for maintaining the improvement in BCVA and CMT in patients with ME associated with BRVO.


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