• Cornea/External Disease

    This prospective, randomized, controlled study found that intravitreal ranibizumab provided significant and sustained visual acuity and anatomic improvement in eyes with macular edema secondary to branch retinal vein occlusion (BRVO) compared with standard grid laser treatment.

    Subjects were 36 patients with unilateral vision loss attributable to macular edema following BRVO randomized to six monthly injections of 0.5 mg ranibizumab followed by as-needed treatment or monthly sham injections. Grid laser was administered at 13 and 25 weeks in both groups if criteria for laser treatment were met.

    At 12 months, mean BCVA was improved significantly in the ranibizumab group compared with the group that received standard-of-care laser treatment only (12.5 ETDRS letters vs. -1.6 ETDRS letters; P = 0.032). The mean central foveal thickness was significantly reduced in the ranibizumab compared with standard-of-care group (361.7 mm vs. 175.6 mm; P = 0.025).

    At 13 and 25 weeks, more patients in the standard-of-care group (68.4 percent, 50.0 percent) received grid laser than in the ranibizumab group (6.7 percent, 8.3 percent). No new ocular or systemic adverse events were observed.

    The authors say that although intravitreal ranibizumab is likely to become the mainstay of treatment for macular edema secondary to BRVO, in addition to the ongoing use of grid laser photocoagulation, there remains the burden of repeated injections and the need for continued close monitoring and treatment until complete recompensation of the retinal venous circulation occurs.

    They note that the endpoint for treatment is still undefined and further long-term studies will be required to address this. Available data suggest that there is considerable variability in terms of patient response to treatment in retinal vein occlusion and treatment regimens need to be customized according to patient needs.