Materials and Methods: A retrospective study was conducted on treatment-naive patients diagnosed with BRVO-related ME between 2022 and 2024. All patients received three consecutive monthly intravitreal injections of either Bevacizumab (IVB, n=29), Aflibercept (IVA, n=19), or Ranibizumab (IVR, n=30). Best-corrected visual acuity (BCVA) and central macular thickness (CMT) were evaluated at baseline and after the third injection.

Results: Mean baseline BCVA (logMAR) was similar across groups (IVB: 0.87±0.46, IVA: 0.91±0.70, IVR: 0.96±0.41; p=0.23), as were baseline CMT values (IVB: 616.9±569.0 ?m, IVA: 609.3±560.5 ?m, IVR: 537.3±504.0 ?m; p=0.258). All three groups showed significant improvement in BCVA and CMT following treatment. Final BCVA improved to 0.57±0.37 in IVB, 0.45±0.29 in IVA, and 0.43±0.29 in IVR. Final CMT reduced to 393.2±343.0 ?m (IVB), 308.0±295.0 ?m (IVA), and 320.5±280.0 ?m (IVR), all with p<0.0001. No statistically significant differences were observed between groups in terms of BCVA or CMT changes (p=0.30 and p=0.36, respectively).

Conclusion: All three anti-VEGF agents were similarly effective in improving visual acuity and reducing macular thickness after three monthly injections. Treatment selection can be guided by availability, cost, and clinical context, as no significant efficacy differences were found in the short term. Keywords : Anti-VEGF, Intravitreal injection, Macular edema, Retinal vein occlusion