2MD, University of Health Sciences, Beyoglu Eye Research and Training Hospital, Department of Ophthalmology, Istanbul, Turkey
3MD, FEBO, FICO, Marmara University School of Medicine, Department of Ophthalmology, Istanbul, Turkey DOI : 10.37845/ret.vit.2022.31.4 Purpose: To compare the therapeutic efficacy of grid laser photocoagulation (GLP) with intravitreal aflibercept (IVA) versus ranibizumab (IVR) on eyes with macular edema (ME) due to branch retinal vein occlusion (BRVO).
Methods: A total of 139 patients (139 naive eyes) with ME caused by BRVO which was received therapy for IVA combined with GLP (72 eyes) against IVR combined with GLP (67 eyes), retrospectively reviewed. Main outcomes for best corrected visual acuity (BCVA), central foveal thickness (CFT), central foveal volume (CFV) and subfoveal choroidal thickness (SFCT) were recorded from baseline to final visit. Spectral-domain optical coherence tomography (SD-OCT) and fundus fluorescein angiography (FFA) were used to show anatomic findings. GLP was implemented over the focal leaks seen on the FFA that used a 532 nm diode laser system. BRVO was classified as ischemic and nonischemic according to FFA findings.
Results: The mean age was 65.49 ± 9.59 years (range; 45 - 87 years) and mean follow-up time was 37.95 ± 13.29 months (range; 13 - 60 months). Average IVA and IVR injection counts from baseline to final visit were 3.84 ± 1.85 (range; 1 to 9) and, 4.89 ± 2.49 (range; 1 to 10) respectively (p=0.011). Mean counts of GLP in IVA and IVR groups from baseline to final visit were 3.4 ± 1.2 (range; 2 to 8) and, 3.5 ± 1.1 (range; 2 to 7), respectively (p=0.610). The mean CFT decreased from baseline to final visit were 537.40 ± 181.84 ?m to 266.43 ± 51.89 ?m in the IVA group, and 528.94 ± 177.52 ?m to 312.59 ± 78.15 ?m in the IVR group (p<0.001). Mean BCVA changes from baseline to final visits were 1.00 ± 0.55 to 0.40 ± 0.36 Logarithm of the Minimal Angle of Resolution (logMAR) in IVA group, and 0.96 ± 0.54 to 0.45 ± 0.38 logMAR in IVR group, respectively (p<0.001). A statistically significant improvement was detected in CFV and SFCT when compared to the baseline in all follow-up visit in both group (p<0.001). Epiretinal membran gelişimi ve başlangıçta seröz retina dekolmanı varlığı açısından iki grup arasında anlamlı bir fark yoktu (p>0.05). There was no statistically significant difference in both CFT and BCVA in eyes with ischemic and non-ischemic BRVO at both group (p>0.05).
Conclusion: Combination therapy with GLP through either IVA or IVR was found to be effective in treatment of ME due to BRVO. Number of injections was less in IVA group than IVR group. Anatomical recovery was observed more in the IVA group.
Keywords : Branch retinal vein occlusion, Aflibercept, Ranibizumab, Macular edema, Grid laser photocoagulation