JOURNAL ARTICLE

Intravitreal ranibizumab (Lucentis) for branch retinal vein occlusion-induced macular edema: nine-month results of a prospective study

Alexander Rouvas, Petros Petrou, Amalia Ntouraki, Maria Douvali, Ioannis Ladas, Ioannis Vergados
Retina 2010, 30 (6): 893-902
20531142

PURPOSE: The purpose of this study was to evaluate the effect of individualized repeated intravitreal injections of ranibizumab (Lucentis, Genentech, South San Francisco, CA) on visual acuity and central foveal thickness (CFT) for branch retinal vein occlusion-induced macular edema.

METHODS: This study was a prospective interventional case series. Twenty-eight eyes of 28 consecutive patients diagnosed with branch retinal vein occlusion-related macular edema treated with repeated intravitreal injections of ranibizumab (when CFT was >225 microm) were evaluated. Optical coherence tomography and fluorescein angiography were performed monthly.

RESULTS: The mean best-corrected distance visual acuity improved from 62.67 Early Treatment of Diabetic Retinopathy Study letters (logarithm of the minimum angle of resolution = 0.74 +/- 0.28 [mean +/- standard deviation]) at baseline to 76.8 Early Treatment of Diabetic Retinopathy Study letters (logarithm of the minimum angle of resolution = 0.49 +/- 0.3; statistically significant, P < 0.001) at the end of the follow-up (9 months). The mean letter gain (including the patients with stable and worse visual acuities) was 14.3 letters (2.9 lines). During the same period, 22 of the 28 eyes (78.6%) showed improved visual acuity, 4 (14.2%) had stable visual acuity, and 2 (7.14%) had worse visual acuity compared with baseline. The mean CFT improved from 349 +/- 112 microm at baseline to 229 +/- 44 microm (significant, P < 0.001) at the end of follow-up. A mean of six injections was performed during the follow-up period. Our subgroup analysis indicated that patients with worse visual acuity at presentation (<or=50 letters in our series) showed greater visual benefit from treatment. "Rebound" macular edema was observed in 5 patients (17.85%) at the 3-month follow-up visit and in none at the 6- and 9-month follow-ups. In 18 of the 28 patients (53.6%), the CFT was <225 microm at the last follow-up visit, and therefore, further treatment was not instituted. No ocular or systemic side effects were noted.

CONCLUSION: Individualized repeated intravitreal injections of ranibizumab showed promising short-term results in visual acuity improvement and decrease in CFT in patients with macular edema associated with branch retinal vein occlusion. Further studies are needed to prove the long-term effect of ranibizumab treatment on patients with branch retinal vein occlusion.

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