Intravitreal bevacizumab associated with grid laser photocoagulation in macular edema secondary to branch retinal vein occlusion.

PURPOSE: To evaluate intravitreal bevacizumab (IVB) combined with grid laser photocoagulation in macular edema (ME) secondary to branch retinal vein occlusion (BRVO).

METHODS: Eight eyes (8 patients) with ME associated with BRVO with at least 3 months of evolution since symptom onset were included. All subjects underwent measurement of best-corrected visual acuity (BCVA) and imaging with spectral domain optical coherence tomography (SD-OCT) at baseline and 1, 3, 6, and 12 months. Intravitreal bevacizumab was administered at baseline and macular grid laser photocoagulation 1 month later. During follow-up, additional IVB was administered based on physician discretion if persistent or recurrent intraretinal fluid (cysts) was observed on SD-OCT. The mean BCVA and SD-OCT central subfield thickness (CST) values were determined at each time point. Fisher exact test was performed to assess differences between baseline and post-treatment BCVA and SD-OCT measurements.

RESULTS: The mean baseline BCVA was 0.28±0.14 (mean±SD), and the mean CST was 479±137 µm. The mean BCVAs at 1, 3, 6, and 12 months were 0.47±0.18 (p=0.031), 0.56±0.50 (p=0.031), 0.65±0.60 (p=0.008), and 0.66±0.65 (p=0.016), respectively. The mean CST values at 1, 3, 6, and 12 months were 295±60 µm (p=0.008), 333±114 µm (p=0.070), 339±80 µm (p=0.008), and 335±109 µm (p=0.008). A mean 2.13 injections were administered; the second injection was administered a mean of 2.71 months after baseline.

CONCLUSIONS: Combined treatment with IVB and macular grid photocoagulation provided good results and may be considered as an alternative therapy for ME in BRVO. Further studies are needed to assess these preliminary results.